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1.
Heart Fail Rev ; 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38498262

RESUMO

Heart failure (HF) can be caused by a variety of causes characterized by abnormal myocardial systole and diastole. Ca2+ current through the L-type calcium channel (LTCC) on the membrane is the initial trigger signal for a cardiac cycle. Declined systole and diastole in HF are associated with dysfunction of myocardial Ca2+ function. This disorder can be correlated with unbalanced levels of phosphorylation / dephosphorylation of LTCC, endoplasmic reticulum (ER), and myofilament. Kinase and phosphatase activity changes along with HF progress, resulting in phased changes in the degree of phosphorylation / dephosphorylation. It is important to realize the phosphorylation / dephosphorylation differences between a normal and a failing heart. This review focuses on phosphorylation / dephosphorylation changes in the progression of HF and summarizes the effects of phosphorylation / dephosphorylation of LTCC, ER function, and myofilament function in normal conditions and HF based on previous experiments and clinical research. Also, we summarize current therapeutic methods based on abnormal phosphorylation / dephosphorylation and clarify potential therapeutic directions.

3.
J Alzheimers Dis ; 96(4): 1651-1661, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38007652

RESUMO

BACKGROUND: APOE ɛ4 and PICALM are established genes associated with risk of late-onset Alzheimer's disease (AD). Previous study indicated interaction of PICALM with APOE ɛ4 in AD patients. OBJECTIVE: To explore whether PICALM variation could moderate the influences of APOE ɛ4 on AD pathology biomarkers and cognition in pre-dementia stage. METHODS: A total of 1,034 non-demented participants (mean age 74 years, 56% females, 40% APOE ɛ4 carriers) were genotyped for PICALM rs3851179 and APOE ɛ4 at baseline and were followed for influences on changes of cognition and cerebrospinal fluid (CSF) AD markers in six years. The interaction effects were examined via regression models adjusting for age, gender, education, and cognitive diagnosis. RESULTS: The interaction term of rs3851179×APOE ɛ4 accounted for a significant amount of variance in baseline general cognition (p = 0.039) and memory function (p = 0.002). The relationships of APOE ɛ4 with trajectory of CSF Aß42 (p = 0.007), CSF P-tau181 (p = 0.003), CSF T-tau (p = 0.001), and memory function (p = 0.017) were also moderated by rs3851179 variation. CONCLUSIONS: APOE ɛ4 carriers experienced slower clinical and pathological progression when they had more protective A alleles of PICALM rs3851179. These findings firstly revealed the gene-gene interactive effects of PICALM with APOE ɛ4 in pre-dementia stage.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Proteínas Monoméricas de Montagem de Clatrina , Feminino , Humanos , Idoso , Masculino , Doença de Alzheimer/psicologia , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Apolipoproteína E4/genética , Proteínas tau/líquido cefalorraquidiano , Biomarcadores/líquido cefalorraquidiano , Apolipoproteínas E/genética , Disfunção Cognitiva/genética , Proteínas Monoméricas de Montagem de Clatrina/genética
4.
Ying Yong Sheng Tai Xue Bao ; 33(10): 2822-2828, 2022 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-36384619

RESUMO

To understand the synergetic features of economy, society, and ecology in cities, we established an urban ecological-economic-social synergetic index evaluation system from three aspects (per capita green area, per capita GDP, and life expectancy per capita) and created an urban ecological-economic-social synergetic index eva-luation method. We analyzed the synergetic features by comparing the ecological-economic-social synergetic index and comprehensive function scores of 35 typical cities in China. The differences in ecological-economic-social synergy and function score for different city sizes and administrative divisions were investigated, while the synergy level of cities were classified. The results showed that the average ecological-economic-social synergetic index of 35 cities in China was 28.79, with the highest of 3.83 and the lowest of 63.04 in 2016. The synergetic index, urban econo-mic function, and social function were significantly positively correlated with urban population sizes and economic sizes. There were significant differences in synergetic index among cities with different population sizes, economic sizes, and administrative functions. The urbanization in China was still in the status of functional imbalance. Urban development was conducive to improve cities' function, but did not effectively improve the synergy of ecology, economy, and society. The ecological function of cities significantly affected urban synergy, which indicated that the poor urban ecological function was the main restrictive factor for urban synergy in China.


Assuntos
Conservação dos Recursos Naturais , Urbanização , China , Cidades , Ecossistema
5.
World J Clin Cases ; 10(24): 8667-8672, 2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36157798

RESUMO

BACKGROUND: Recently, two naval pilots in a two-seat trainer jet were forced to eject urgently due to sudden mechanical failure during night-time training. They were both successfully rescued and sent to the hospital for emergency treatment. In this study, we investigate their ejection injuries and recovery process. CASE SUMMARY: We analyzed the clinical data of the traumatic condition and recovery process from ejection injuries of two pilots who ejected from a failed trainer jet and survived. After being successfully rescued and sent to the hospital, they were diagnosed with multiple ejection injuries, including eye trauma, limb bone and joint injury, rib and spine injury, and so on. Both cases underwent fluid replacement, acid suppression, nutritional support, hemostasis, bone metabolism improvement, phlegm elimination, psychological measurement, blood circulation promotion and detumescence, physical therapy, and external fixation with braces for 1 mo before being discharged from hospital. They then recuperated in a sanatorium for 2 mo, and the related laboratory tests and supplementary examinations show that they recovered from all the above injuries. After successfully passing the psychological test and physical examination, they returned to flight duty 3 mo after ejection. CONCLUSION: The causes and conditions of ejection injury in the pilots were very complex. Although they finally recovered quickly and were released, it also serves as a reminder that attention should be paid to pilots' ejection and parachute training in order to significantly reduce ejection injury and improve the ejection success rate. In addition, air defense support personnel should strengthen search and rescue and on-site emergency measures, and locate and rescue pilots in distress as early as possible to reduce subsequent injuries.

6.
World J Clin Cases ; 10(16): 5487-5494, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35812691

RESUMO

BACKGROUND: Specific pulmonary infection could seriously threaten the health of pilots and their companions. The consequences are serious. We investigated the clinical diagnosis, treatment, and medical identification of specific pulmonary infections in naval pilots. CASE SUMMARY: We analyzed the medical waiver and clinical data of four pilots with specific pulmonary infections, who had accepted treatment at the Naval Medical Center of Chinese People's Liberation Army between January 2020 and November 2021, including three cases of tuberculosis and one of cryptococcal pneumonia. All cases underwent a series of comprehensive treatment courses. Three cases successfully obtained medical waiver for flight after being cured, while one was grounded after reaching the maximum flight life after being cured. CONCLUSION: Chest computed tomography scanning should be used instead of chest radiography in pilots' physical examination. Most pilots with specific pulmonary infection can be cured and return to flight.

7.
J Neurol Surg A Cent Eur Neurosurg ; 83(2): 129-134, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34634827

RESUMO

BACKGROUND AND STUDY AIMS: Although laminectomy with lateral mass screw fixation (LCSF) is an effective surgical treatment for cervical spondylotic myelopathy (CSM), loss of cervical curvature may result. This study aimed to investigate the effect of cervical curvature on spinal cord drift distance and clinical efficacy. PATIENTS AND METHODS: We retrospectively analyzed 78 consecutive CSM patients with normal cervical curvature who underwent LCSF. Cervical curvature was measured according to Borden's method 6 months after surgery. Study patients were divided into two groups: group A, reduced cervical curvature (cervical lordosis depth 0-7mm; n = 42); and group B, normal cervical curvature (cervical lordosis depth 7-17mm; n = 36). Spinal cord drift distance, laminectomy width, neurologic functional recovery, axial symptom (AS) severity, and incidence of C5 palsy were measured and compared. RESULTS: Cervical lordosis depth was 5.1 ± 1.2 mm in group A and 12.3 ± 2.4 mm in group B (p < 0.05). Laminectomy width was 21.5 ± 2.6 mm in group A and 21.9 ± 2.8 mm in group B (p > 0.05). Spinal cord drift distance was significantly shorter in group A (1.9 ± 0.4 vs. 2.6 ± 0.7 mm; p < 0.05). The Japanese Orthopaedic Association (JOA) score significantly increased after surgery in both groups (p < 0.05). Neurologic recovery rate did not differ between the two groups (61.5 vs. 62.7%; p > 0.05). AS severity was significantly higher in group A (p < 0.05). C5 palsy occurred in three group A patients (7.1%) and four group B patients (11.1%), but the difference was not significant (p > 0.05). CONCLUSION: After LCSF, 53.8% of the patients developed loss of cervical curvature. A smaller cervical curvature resulted in a shorter spinal cord drift distance. Loss of cervical curvature was related to AS severity but not improvement of neurologic function or incidence of C5 palsy.


Assuntos
Laminectomia , Doenças da Medula Espinal , Parafusos Ósseos , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Humanos , Laminectomia/métodos , Estudos Retrospectivos , Medula Espinal/cirurgia , Doenças da Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/cirurgia , Resultado do Tratamento
8.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-965136

RESUMO

@#Abstract: Objective ( ) To evaluate the internal exposure levels and risk in nuclear medicine workers NMWs engaged in Methods radionuclide therapy in Guangdong Province. A total of 61 NMWs from eight hospitals in Guangdong Province were selected as the study subjects using the convenient sampling method. The 0.364 MeV full energy peak efficiency was detected in ( ) in vitro , - deltoid muscle of right upper arm as background and thyroid gland by direct measurement method and the iodine 131 (131 ) Results ,131 I activity in thyroid gland was calculated to evaluate the internal irradiation level. Among the 61 NMWs I was , detected in the thyroid gland of four nuclear medical staffs in three hospitals and the detection rate was 6.6%. The median and - [M( P-P )] 131 ( - ) 0 100 percentile 0 100 of thyroid I activity were 42.9 35.1 47.1 Bq. When assuming that the monitoring period was , M( P-P ) ( - ) , 30 days the 0 100 of single committed effective dose in thyroid gland was 0.014 0.011 0.015 mSv and the annual dose ( - ) Conclusion of internal irradiation was 0.162 0.132 0.180 mSv/a. The internal exposure of NMWs in the eight hospitals in ( ) , Guangdong Province meets the annual effective dose limits ≤20.000 mSv/a . However it is necessary to pay attention to the internal radiation protection of NMWs and take reasonable protective measures to reduce the internal exposure risk of NMWs.

9.
Front Oncol ; 11: 722325, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422668

RESUMO

BACKGROUND: The genomic tests such as the MammaPrint and Oncotype DX test are being gradually applied for hormone receptor positive/HER-2 negative (HR+/HER2-) breast cancer patients with up to three positive axillary lymph nodes (ALNs). The first results from RxPONDER trial suggested that Oncotype DX could be applied to patients with 1-2 positive sentinel lymph nodes (SLNs) without axillary lymph node dissection (ALND), which constituted 37.4% of the intent-to-treat population. However, there was no distinctive research on how to apply genomic tests precisely to HR+/HER2- patients with 1-2 positive SLNs without ALND. The purpose was to construct a nomogram using the multi-center retrospective data to predict precisely which HR+/HER2- candidates with 1-2 positive SLNs could be subjected to genomic tests (≤ 3 positive lymph nodes). METHODS: We conducted a retrospective analysis of 18,600 patients with stage I-III breast cancer patients treated with sentinel lymph node biopsy (SLNB) in Shandong Cancer Hospital, Fudan University Shanghai Cancer Center, and West China Hospital. The univariate and multivariate logistic regression analysis was conducted to identify the independent predictive factors of having ≤ 3 positive nodes among patients with 1-2 positive SLNs. A nomogram was developed based on variables in the final model with p<0.05. Calibration of the nomogram was carried out by internal validation using the bootstrap resampling approach and was displayed using a calibration curve. The discrimination of the model was evaluated using the ROC curve. RESULTS: Based on the database of the three institutions, a total of 18,600 breast cancer patients were identified undergoing SLNB between May 2010 and 2020. Among the 1817 HR+/HER2- patients with 1-2 positive SLNs undergoing ALND, 84.2% harbored ≤ 3 totals metastatic ALNs. The multivariate logistic regression analysis identified imaging abnormal nodes (OR=0.197, 95%CI: 0.082-0.472), the number of positive SLNs (OR=0.351, 95%CI: 0.266-0.464), the number of negative SLNs (OR=1.639, 95%CI: 1.465-1.833), pathological tumor stage (OR=0.730, 95%CI: 0.552-0.964), and lympho-vascular invasion (OR=0.287, 95%CI: 0.222-0.398) as independent predictors for the proportion of patients with ≤ 3 total metastatic ALNs (all p<0.05). These five predictors were used to create a predictive nomogram. The AUC value was 0.804 (95%CI: 0.681-0.812, p<0.001). The calibration curve showed a satisfactory fit between the predictive and actual observation based on internal validation with a bootstrap resampling frequency of 1000. CONCLUSION: The nomogram based on the multi-centric database showed a good accuracy and could assist the oncologist in determining precisely which HR+/HER2- candidates with 1-2 positive SLNs without ALND could perform genomic tests. In the era of SLNB and precision medicine, the combined application of genomic tests and SLNB could provide patients with a better strategy of dual de-escalation management, including the de-escalation of both surgery and systemic treatment.

10.
Future Oncol ; 17(19): 2449-2460, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33878939

RESUMO

The purpose was to integrate clinicopathological and laboratory indicators to predict axillary nodal pathologic complete response (apCR) after neoadjuvant therapy (NAT). The pretreatment clinicopathological and laboratory indicators of 416 clinical nodal-positive breast cancer patients who underwent surgery after NAT were analyzed from April 2015 to 2020. Predictive factors of apCR were examined by logistic analysis. A nomogram was built according to logistic analysis. Among the 416 patients, 37.3% achieved apCR. Multivariate analysis showed that age, pathological grading, molecular subtype and neutrophil-to-lymphocyte ratio were independent predictors of apCR. A nomogram was established based on these four factors. The area under the curve (AUC) was 0.758 in the training set. The validation set showed good discrimination, with AUC of 0.732. In subtype analysis, apCR was 23.8, 47.1 and 50.8% in hormone receptor-positive/HER2-, HER2+ and triple-negative subgroups, respectively. According to the results of the multivariate analysis, pathological grade and fibrinogen level were independent predictors of apCR after NAT in HER2+ patients. Except for traditional clinicopathological factors, laboratory indicators could also be identified as predictive factors of apCR after NAT. The nomogram integrating pretreatment indicators demonstrated its distinguishing capability, with a high AUC, and could help to guide individualized treatment options.


Lay abstract The purpose of this study was to integrate more pretreatment indicators, including clinicopathological factors and simple laboratory indicators, to predict axillary nodal pathologic complete response (apCR) after neoadjuvant therapy for breast cancer. The authors collected the pretreatment clinicopathological factors and laboratory indexes of 416 nodal-positive patients with breast cancer. The authors then built a nomogram to predict the therapeutic effect in axillary lymph nodes. Among 416 patients, 37.3% (155 of 416) achieved apCR. The results showed that age, pathological grading, molecular subtype and neutrophil-to-lymphocyte ratio were independent predictors of apCR. Based on these four factors, a nomogram was then built. This nomogram helped to predict apCR. In addition to traditional clinicopathological factors, laboratory indicators were also identified as predictive factors of apCR after neoadjuvant therapy. Integrating pretreatment indicators might help to predict apCR and guide individualized treatment options.


Assuntos
Biomarcadores Tumorais/sangue , Neoplasias da Mama/terapia , Metástase Linfática/diagnóstico , Terapia Neoadjuvante/métodos , Nomogramas , Adulto , Idoso , Axila , Neoplasias da Mama/sangue , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Quimioterapia Adjuvante/métodos , Feminino , Fibrinogênio/análise , Humanos , Excisão de Linfonodo , Linfonodos/efeitos dos fármacos , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática/terapia , Mastectomia , Pessoa de Meia-Idade , Gradação de Tumores , Curva ROC , Estudos Retrospectivos , Resultado do Tratamento
11.
Ultrasound Med Biol ; 47(6): 1475-1483, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33714619

RESUMO

The objective was to explore the clinical value of contrast-enhanced ultrasound (CEUS) in locating the sentinel lymph node (SLN) in patients with early breast cancer. We screened 143 consecutive patients with breast cancer between July 2017 and August 2019. The number of SLNs identified by CEUS and dual labeling (blue dye and radiolabeled colloid) were recorded. The accuracy of CEUS plus fine-needle aspiration cytology (FNAC) was assessed. The rate of identification of SLNs with CEUS was 84.0% (121/144), and that of dual labeling was 97.92% (141/144). There was no significant association between non-enhancement (p = 0.060) or inhomogeneous enhancement (p = 0.468) and lymph node metastasis. The sensitivity and specificity of CEUS-SLNs plus FNAC was 78.38% and 100%, respectively. The technique of CEUS is a promising method for locating the axillary SLN. But it is hard to identify lymph node metastasis with CEUS alone. CEUS-SLNs plus FNAC is a sound technique for diagnosis of the metastasis of SLN.


Assuntos
Neoplasias da Mama/patologia , Meios de Contraste , Metástase Linfática/diagnóstico por imagem , Linfonodo Sentinela/diagnóstico por imagem , Adulto , Axila , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Ultrassonografia/métodos
12.
Breast Cancer Res Treat ; 184(2): 397-405, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32776291

RESUMO

BACKGROUND AND PURPOSE: Paclitaxel-based regimens are widely used in the neoadjuvant therapy (NAT) of breast cancer. The purpose is to analysis the efficacy and adverse events (AEs) among common paclitaxel (PTX), docetaxel and liposomal paclitaxel. At the same time, we want to analysis the axillary nodal pathologic complete response (apCR) after NAT among the three groups. METHODS: From April 2014 to 2020, 647 breast cancer patients underwent operation after NAT were included in this study. Patients received full course of anthracycline- and paclitaxel-based chemotherapy before surgery. The paclitaxel-based regimens included PTX, docetaxel and liposomal paclitaxel. The therapy efficacy and AEs of the three groups were evaluated. At the same time, the apCR was also analyzed. RESULTS: In general, 30.6% (198/647) of patients achieved breast pathologic complete response (bpCR), which was 28.6%, 28.3% and 39.3% among PTX, docetaxel and liposomal paclitaxel group, respectively (p = 0.067). The total pathologic complete response (tpCR) (achieving both bpCR and apCR) was 21.6% (140/647). The tpCR was 13.3%, 19.4% and 34.4% among PTX, docetaxel and liposomal paclitaxel group, respectively (p = 0.026). The multivariate logistic analysis result showed that clinical tumor stage and molecular subtype were significantly associated with tpCR (all p < 0.05). Among 592 clinical positive patients (cN+), the apCR was 39.0% (231/592). The multivariate logistic analysis showed that paclitaxel- based regimens and molecular subtype were indicated as independent predictors for apCR of NAT. The apCR was significantly higher in liposomal paclitaxel group (63.5%) than in PTX (24.6%) and docetaxel group (34.8%) (p < 0.001). The subgroup analysis among different molecular subtypes found that in triple negative (TN) and HER-2 positive (HER2+) subgroup, the apCR in liposomal paclitaxel group was significantly higher than those in PTX and docetaxel group (all p < 0.05). But no significant result was found in the subgroup analysis in hormone receptor positive/HER-2 negative subgroup (p = 0.050). Safety analysis indicated that the incidence of neutropenia (grade III-IV) and peripheral neurotoxicity (grade I-II) was significantly lower in the liposomal paclitaxel group than in the PTX and docetaxel group. The incidence of oral mucositis, anaphylaxis and palmar-plantar erythrodysesthesia syndrome was also much lower in liposomal paclitaxel than other two groups (all p < 0.05). And there was no significant difference in other AEs among the three groups (all p > 0.05). CONCLUSION: Liposome paclitaxel had similar tumor suppressor effect compared with PTX and docetaxel in NAT setting. Moreover, it had a better axillary lymph node (ALN) response after NAT than PTX and docetaxel. These patients who received liposome paclitaxel had more chance to avoid ALN dissection after NAT. At the same time, the application of liposome enables liposome paclitaxel could significantly reduce AEs caused by chemotherapy. Therefore, we suggested the application of liposome paclitaxel in the NAT setting, especially for cN+ patients with TN and HER2 + disease.


Assuntos
Neoplasias da Mama , Terapia Neoadjuvante , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Docetaxel/efeitos adversos , Feminino , Humanos , Paclitaxel/efeitos adversos , Receptor ErbB-2
13.
IEEE Trans Neural Syst Rehabil Eng ; 28(3): 621-628, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31985430

RESUMO

Most types of spinal cord injury (SCI) observed in humans can be replicated in adult rat models, which are widely used for laboratory studies of SCI rehabilitation. To ensure the effectiveness and efficiency of an SCI rat model, the minimal time spent performing the laminectomy procedure and the damage caused to the body are of great importance. We describe and evaluate the effectiveness and advantages of a laminectomy auxiliary device (LAD) for removing the rat vertebral lamina without injuring the spinal cord. The incision size, success rate, operation duration, body weight, BBB score, step detection, latency and amplitude of transcranial electrical motor-evoked potentials (tceMEPs), and serum MDA and SOD levels were recorded in 8 normal rats, 8 rats treated with traditional laminectomy and 8 rats treated with LAD laminectomy. Compared with traditional laminectomy, in our LAD, the surgical incision was smaller (approximately 2.2 and 1.3 cm, respectively), the success rate was higher (88.89% and 100%, respectively) and the duration shorter (14.644±1.617 and 4.821±0.668 minutes, respectively). Compared with normal rats, those treated with either laminectomy using LAD or the traditional method showed slower body weight gain and temporarily increased oxidative stress levels. However, there were no significant differences between these two groups. Our results show that laminectomy using this LAD provides three main advantages in rats: a high success rate, time savings, small incisions and reduced trauma. We believe this LAD can be used as an effective assistant tool for rodent laminectomy.


Assuntos
Laminectomia , Traumatismos da Medula Espinal , Animais , Modelos Animais de Doenças , Potencial Evocado Motor , Ratos , Medula Espinal
15.
Ann Surg Oncol ; 27(2): 375-383, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31407178

RESUMO

BACKGROUND: Routine performance of internal mammary sentinel lymph node biopsy (IM-SLNB) remains a subject of debate due to no clinical relevance in breast cancer, because it was performed only in clinically axillary lymph node (ALN)-negative patients. In this study, IM-SLNB was performed in clinically ALN-positive patients, and its impact on nodal staging and therapeutic strategy were subsequently analyzed. METHODS: Clinically ALN-positive patients who underwent IM-SLNB were enrolled in this prospective study. Statistical analysis was performed using Chi square test, Mann-Whitney U and logistic regression models with a significance level of 0.05. RESULTS: Among the 352 recruited patients, the internal mammary sentinel lymph node (IMSLN) visualization rate of patients who received initial surgery and neoadjuvant systemic therapy (NST) was 71.9% (123/171) and 33.1% (60/181), respectively. The 183 patients who underwent IM-SLNB successfully had the average time duration of 7 min and the median IMSLN number of 2. There were 87 positive IMSLNs in all the 347 removed IMSLNs, which were mainly concentrated in the second (50.6%) and third (34.5%) intercostal space. The IMSLN metastasis rate was 39.8% (initial surgery) and 13.3% (NST), respectively. All of the 183 IM-SLNB patients received more accurate nodal staging, 57 of whom had stage elevated, which might have prompted modifications to the therapeutic strategy. CONCLUSIONS: IM-SLNB should be routinely performed in clinically ALN-positive patients, and thus more accurate nodal staging and perfect pathologic complete response definition could be put forward. The identification of IMLN metastases by IM-SLNB might potentially influence therapeutic strategies.


Assuntos
Neoplasias da Mama/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Lobular/diagnóstico , Linfonodos/patologia , Adulto , Idoso , Axila , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/cirurgia , Carcinoma Lobular/cirurgia , Estudos de Casos e Controles , Gerenciamento Clínico , Feminino , Seguimentos , Humanos , Linfonodos/cirurgia , Pessoa de Meia-Idade , Seleção de Pacientes , Prognóstico , Estudos Prospectivos , Biópsia de Linfonodo Sentinela
16.
Breast J ; 25(6): 1154-1159, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31332886

RESUMO

This study aimed to explore the optimal time of sentinel lymph node biopsy (SLNB) and neo-adjuvant chemotherapy (NAC) and to assess the feasibility of selective elimination of axillary surgery after NAC in clinically node-negative (cN0) patients. From April 2010 to August 2018, 845 patients undergoing surgery after NAC were included in this retrospective study to analyze the correlation between different clinicopathological characteristics of cN0 patients and negative axillary lymph node after NAC (ypN0). Among the 148 cN0 patients, 83.1% (123/148) were ypN0. The rates of ypN0 in patients with hormone receptor positive (HR+)/HER2-, HR+/HER2+, HR-/HER2+, and triple-negative (TN) breast cancer were 75.4% (46/61), 82.6% (19/23), 85.2% (23/27), and 94.6% (35/37), respectively (P < 0.001). The rates of ypN0 in TN and HER2+ patients were 94.6% and 95.5%, which were significantly higher than that in HR+/HER2- patients (P < 0.05). Molecular subtypes, clinical stage, radiologic complete response, and pathologic complete response (bpCR) of the breast tumor correlated with ypN0 after full-course NAC (P < 0.05). Molecular subtypes (OR = 2.374, P = 0.033), clinical stage (OR = 0.320, P = 0.029), and bpCR (OR = 0.454, P = 0.012) were independent predictors for ypN0. The optimal time of SLNB and NAC in cN0 patients might be different among different molecular subtypes: it would be preferable to perform SLNB prior to NAC for HR+/HER2- patients, and SLNB after NAC for TN and HER2+ patients to reduce the risk of axillary lymph node dissection. In view of the high ypN0 rate in cN0 patients, axillary surgical staging might be selectively eliminated, especially for HER2+ and TN patients.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Adulto , Idoso , Axila/diagnóstico por imagem , Axila/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Quimioterapia Adjuvante/métodos , Feminino , Humanos , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Pessoa de Meia-Idade , Cintilografia , Estudos Retrospectivos , Biópsia de Linfonodo Sentinela/efeitos adversos , Biópsia de Linfonodo Sentinela/métodos
17.
Sci Rep ; 7(1): 6366, 2017 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-28743880

RESUMO

Most of Quantum Secret Sharing(QSS) are (n, n) threshold 2-level schemes, in which the 2-level secret cannot be reconstructed until all n shares are collected. In this paper, we propose a (t, n) threshold d-level QSS scheme, in which the d-level secret can be reconstructed only if at least t shares are collected. Compared with (n, n) threshold 2-level QSS, the proposed QSS provides better universality, flexibility, and practicability. Moreover, in this scheme, any one of the participants does not know the other participants' shares, even the trusted reconstructor Bob 1 is no exception. The transformation of the particles includes some simple operations such as d-level CNOT, Quantum Fourier Transform(QFT), Inverse Quantum Fourier Transform(IQFT), and generalized Pauli operator. The transformed particles need not to be transmitted from one participant to another in the quantum channel. Security analysis shows that the proposed scheme can resist intercept-resend attack, entangle-measure attack, collusion attack, and forgery attack. Performance comparison shows that it has lower computation and communication costs than other similar schemes when 2 < t < n - 1.

18.
Cancer Chemother Pharmacol ; 79(5): 1003-1011, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28391353

RESUMO

PURPOSE: The mechanisms underlying the oncogenic properties of WW domain binding protein 2 (WBP2) in breast cancer have not been fully understood. In this study, we explored the role of WBP2 in cell cycle regulation in ER+ breast cancer cells and how it is regulated in the cancer cells. METHODS: The association between WBP2 expression and prognosis in ER+ breast cancer was assessed by data mining in Breast Cancer Gene-Expression Miner v4.0. Cell cycle was assessed by PI staining and flow cytometry. EdU staining was applied to visualize cells in S phase. The binding between miR-206 and WBP2 were verified by dual luciferase assay. CCK-8 assay and flow cytometric analysis were applied to assess the functional role of WBP2 and miR-206 in the cancer cells. RESULTS: High WBP2 expression correlates with higher risk of any events (AE) and metastatic relapse (MR) and also indicates shorter AE-free survival and MR-free survival in ER+ breast cancer patients. In both MCF-7 and BT474 cells, WBP can influence the expression of G1/S-related cell cycle proteins, including p21, CDK4, and cyclin D1. In addition, WBP2 overexpression resulted in facilitated G1/S transition, while WBP2 knockdown impaired the transition. The 3'UTR of WBP2 has a conserved miR-206 binding site. Functionally, miR-206 knockdown decreased tamoxifen sensitivity in tamoxifen-sensitive (TamS) MCF-7 cells, while miR-206 overexpression and WBP2 knockdown enhanced the sensitivity in tamoxifen-resistant (TamR) MCF-7 cells. CONCLUSION: Based on these findings, we infer that the miR-206/WBP2 axis can modulate tamoxifen sensitivity via regulating G1/S progression in ER+ breast cancer.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Fase G1/genética , MicroRNAs/genética , Receptores de Estrogênio/genética , Fase S/genética , Regiões 3' não Traduzidas/genética , Antineoplásicos Hormonais/farmacologia , Sítios de Ligação , Proteínas de Ciclo Celular/genética , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Resistencia a Medicamentos Antineoplásicos/genética , Feminino , Técnicas de Silenciamento de Genes , Humanos , Células MCF-7 , Prognóstico , Tamoxifeno/farmacologia , Transativadores
19.
Oncotarget ; 7(45): 74074-74081, 2016 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-27738336

RESUMO

With the improvement of neoadjuvant chemotherapy (NAC), the proportion of pathological complete response (pCR) in the breast and axillary lymph node (ALN) is increasing. The evaluation of pCR does not include the status of internal mammary lymph node (IMLN). This study is to evaluate the roles of both axillary sentinel lymph node biopsy (ASLNB) and internal mammary sentinel lymph node biopsy (IM-SLNB) in breast cancer patients after NAC. There were 74 patients enrolled into this study. IM-SLNB was performed on patients with radioactive internal mammary sentinel lymph node (IM-SLN). Patients (n = 8) with cN0 and ycN0 received ASLNB, and axillary lymph node dissection (ALND) in cases of positive axillary sentinel lymph node (ASLN). Patients (n = 48) with cN+ but ycN0 received ASLNB and ALND. Patients (n = 18) with ycN+ received ALND without ASLNB. The visualization rate of IM-SLN was 56.8% (42/74). The success rate of IM-SLNB was 97.6% (41/42) and the metastasis rate of IM-SLN was 7.3% (3/41). The success rate of ASLNB was 100% (56/56). The false negative rate (FNR) of ASLNB was 17.2% (5/29). The FNR in patients with 1, 2 and ≥ 3ASLNs examined was 27.3% (3/11), 20.0% (2/10) and 0% (0/8) respectively. ASLNB could be performed on ycN0 after NAC, and ALND should be performed on initially ALN-positive patients. IM-SLNB should be considered after NAC, especially for patients with clinically positive axillary nodes before NAC, which might help make clear of the pathological nodal staging of both ALN and IMLN, improve the definition of nodal pCR, and guide the individual adjuvant regional and systemic therapy.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Biópsia de Linfonodo Sentinela/métodos , Adulto , Idoso , Axila , Feminino , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Terapia Neoadjuvante
20.
Oncotarget ; 7(30): 47526-47535, 2016 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-27374088

RESUMO

An appropriate receptor-targeted tracer for sentinel lymph node biopsy (SLNB) was prepared. We combined the fluorescence tracer (Indocyanine green, ICG) with Rituximab (a chimeric human/murine monoclonal antibody targeting the CD20 antigen on the surface of lymphocyte) directly to produce a new tracer (ICG-Rituximab). When the new tracer drains to the lymph node, Rituximab will combine with CD20 receptor on the B-cell surface in the lymph node. If the statue of antibody-receptor connection does not reach saturation, the number of Rituximab is less than CD20. With this appropriate injection dose, the new tracer could only stay in sentinel lymph node (SLN) and make it imaging. Positive fluorescence SLN was detected 12 minutes after injection with no other organs imaging. The imaging of SLN was stable and clear for 20-24 hours. Due to SLN stained with more ICG than the lymphatic vessel, the fluorescence situation of SLN would be brighter than the vessel. The surgeon can detect the positive fluorescence SLN easily without following the fluorescence imaging lymphatic vessel. The results of our preliminary study showed that the new tracer might be useful for improving SLN imaging and worth further clinical study. SLNB with the new tracer could be a convenient method for detecting SLN and would become a standard performance in clinical practice.


Assuntos
Neoplasias da Mama/patologia , Verde de Indocianina , Rituximab/metabolismo , Biópsia de Linfonodo Sentinela/métodos , Linfonodo Sentinela/diagnóstico por imagem , Animais , Feminino , Fluorescência , Masculino , Camundongos , Camundongos Endogâmicos BALB C
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