Maternal exposure to particulate matter from duck houses restricts fetal growth due to inflammatory damage and oxidative stress.

The composition of particulate matter (PM) in poultry farms differs significantly from that of atmospheric PM as there is a higher concentration of microbes on farms. To assess the health effects of PM from poultry farms on pregnant animals, we collected PM from duck houses using a particulate sampler, processed it via centrifugation and vacuum concentration, and subsequently exposed the mice to airborne PM at 0.48 mg/m3 (i.e., low concentration group) and 1.92 mg/m3 (i.e., high concentration group) on the fifth day of pregnancy. After exposure until the twentieth day of pregnancy or spontaneous delivery, mice were euthanized for sampling. The effects of PM from duck houses on the pregnancy toxicity of mice were analyzed using histopathological analysis, enzyme-linked immunosorbent assay, and quantitative real-time polymerase chain reaction (qPCR). The results showed that exposure to PM had adverse effects on pregnant mice that reduced their feed intake in both groups. Microscopic lesions were observed in the lungs and placentas of pregnant mice, and the lesions worsened with increased PM concentrations, as shown by alveolar wall thickening, the infiltration of inflammatory cells in pulmonary interstitium, congestion, edema, and cellular degeneration of placenta. In pregnant mice in the high concentration group, exposure to PM significantly increased the expression of inflammatory cytokines in the lungs and placentas, caused oxidative stress, and decreased estrogen level in the blood. Exposure to PM also resulted in the reduced litter sizes of pregnant mice and shorter body and tail lengths in the fetuses delivered. Beyond that, exposure to PM significantly downregulated the levels of antioxidant factor superoxide dismutase and neurotrophic factor Ngf in the brains of fetuses. Collectively, exposure to a high concentration of PM by inhalation among pregnant mice caused significant pregnancy toxicity that led to abnormal fetal development due to inflammatory damage and oxidative stress. These findings established a foundation for future studies on the underlying mechanisms of pregnancy toxicity induced by exposure to PM.

Optical frequency domain reflectometry with broadened frequency sweep range assisted by a dual electro-optic frequency comb.

We propose an optical frequency domain reflectometry (OFDR) with the assistance of a dual electro-optic frequency comb (EOFC), which is intended to improve the system spatial resolution. As the spatial resolution of an OFDR system is inversely proportional to the frequency sweep range, the EOFC acts as a multi-frequency light source for collecting Rayleigh backscattering signals, which are combined to extend the effective frequency sweep range. By utilizing this technique, we have successfully expanded the experimental frequency sweep range to hundreds of gigahertz, achieving a sub-millimeter spatial resolution.

Rayleigh speckle-based wavemeter with high dynamic range and fast reference speckle establishment process assisted by optical frequency combs.

Compact speckle-based spectrometers that acquire lightwave wavelength from the speckle generated by turbid media are promising for high-resolution spectral analysis. For these devices, the reference establishment process is time consuming, and it is very difficult to obtain reference speckles covering a wide bandwidth with high resolution, which restricts the dynamic range in frequency (the ratio of bandwidth to resolution). In this Letter, we introduce optical frequency combs (OFCs) to the system to overcome these problems, which exist in the wavemeter based on Rayleigh speckle obtained from a single-mode fiber. In the experiment, the proposed wavemeter has a 1.5 nm bandwidth with 60 am resolution, covering a dynamic range in the frequency of 2×107, and a fast reference speckle establishment process that takes only 0.9 ms. The proposed method assisted by OFCs is a good prospect for a more practical speckle-based wavemeter with higher dynamic ranges.

Laboratory indicators predict axillary nodal pathologic complete response after neoadjuvant therapy in breast cancer.

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.

Neoadjuvant therapy and sentinel lymph node biopsy in HER2-positive breast cancer patients: results from the PEONY trial.

OBJECTIVE: The aim of the study is to evaluate the optimal timing of sentinel lymph node biopsy (SLNB) in patients with clinical negative axillary lymph nodes (ALNs) before neoadjuvant therapy (NAT) and the feasibility of SLNB substituting for ALN dissection in patients with positive ALNs who convert to node negative, for HER2-positive disease. METHODS: Patients receiving SLNB with dual tracer mapping in the PEONY trial were analyzed. RESULTS: For 80 patients with clinical negative ALNs, the node negative rate by pathology after NAT was 83.8%. SLNB was performed after NAT in 71 patients. The identification rate of sentinel lymph nodes (SLNs) was 100%. For patients with positive ALNs before NAT, the axillary pathologic complete response rate in the dual HER2 blockade arm was significantly higher than that in the single blockade arm (p = 0.002). SLNB was performed in 71 patients. The identification rate was 100% and the false-negative rate was 17.2%. The false-negative rates were 33.3%, 14.3%, and 0 when 1, 2, and more than 2 SLNs were detected. There was no false-negative case when more than 1 SLN and the clipped nodes were removed simultaneously. CONCLUSIONS: For clinical ALN negative patients, HER2-positive subtype is found to have high node negative rate by pathology and it is recommended to undergo SLNB after NAT. For patients with positive ALNs who convert to negative, the false-negative rate is high. Dual tracer mapping, more than 2 SLNs detected, more than 1 SLN identified plus the clips placed are the guarantees for lower false-negative rate.

Long-range and wide-band vibration sensing by using phase-sensitive OFDR to interrogate a weak reflector array.

In this paper, we propose and experimentally demonstrate a novel quasi-distributed fiber-optic vibration sensing system, which can achieve vibration measurement with a wide frequency response over a long distance. The system is based on phase-sensitive optical frequency domain reflectometry (ϕ-OFDR). The sensing part is a single-mode fiber (SMF) with auxiliary weak reflection points along it. By detecting the auxiliary weak reflection points, we can obtain the waveform of the vibration signal. In the experiments, single-point and multi-point vibrations with a wide-frequency response at 100 km are successfully measured, which validated the proposed system. To the best of our knowledge, this is the first time to realize a wide-band vibration waveform measurement over such a long range by using reflectometry-based sensing system.

High-resolution wavemeter using Rayleigh speckle obtained by optical time domain reflectometry.

The characteristics of Rayleigh speckle generated from a single-mode fiber are related to the wavelength of the incident lightwave, which makes it possible to use Rayleigh speckle for spectrum measurement. Based on this feature, we propose, to the best of our knowledge, a novel wavemeter with high resolution realized using optical time domain reflectometry to obtain Rayleigh speckle. We show that the spectral resolution is inverse to the probe pulse width, with a spectral resolution of 6 fm corresponding to a 2 µs probe pulse. A correlation coefficient method is introduced to further increase the spectral resolution from 6 to 0.4 fm. Moreover, it is experimentally demonstrated that the system has the capability to resolve dynamic multi-wavelength signals with 25 µs time resolution. The proposed high-resolution wavemeter is a good prospect for cost effectiveness, compactness, and excellent performance of spectral resolution.

Predicting essential proteins from protein-protein interactions using order statistics.

Many computational methods have been proposed to predict essential proteins from protein-protein interaction (PPI) networks. However, it is still challenging to improve the prediction accuracy. In this study, we propose a new method, esPOS (essential proteins Predictor using Order Statistics) to predict essential proteins from PPI networks. Firstly, we refine the networks by using gene expression information and subcellular localization information. Secondly, we design some new features, which combine the protein predicted secondary structure with PPI network. We show that these new features are useful to predict essential proteins. Thirdly, we optimize these features by using a greedy method, and combine the optimized features by order statistic method. Our method achieves the prediction accuracy of 0.76-0.79 on two network datasets. The proposed method is available at https://sourceforge.net/projects/espos/.

Neo-adjuvant chemotherapy and axillary de-escalation management for patients with clinically node-negative breast cancer.

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.

A mechanistic study of geminal dicationic ionic liquids as mobile phase additives for improving the separation performance of high-performance liquid chromatography.

Due to the acidity and strong polarity of auxinic herbicides, separation of these compounds in food and environmental samples is a great challenge. In this study, 12 geminal dicationic ionic liquids (GDILs) were synthesized and used as mobile phase additives to separate six auxinic herbicides. The effects of the kind of dication, the length of linkage chain, the kind of anion, the concentration of GDILs, and the pH of mobile phase for the separation were investigated in detail. Compared with [C4MIm][BF4], GDILs ([C8(MIm)2][BF4]2) showed higher resolution, better peak shape, and lower retention factor. The separation performance of additives was in the order of [C8(MIm)2][BF4]2 > [C8(MPy)2][BF4]2, [(C4)2MPiz][BF4]2, [C8(MMo)2][BF4]2, [C4MIm][BF4], [C8(MPid)2][BF4]2 > [C8(HBOc)2][BF4]2 > TBAB. GDILs showed the best separation under the following conditions: cation: imidazolium; length of linkage chain: 8; anion: BF4-; mobile phase pH: 3; concentration: 5 mmol L-1. The separation mechanism of GDILs may mainly be due to their symmetric structure and the abundance of positive charge sites which could help GDILs shield the residual silanol and interact with analytes more efficiently to improve the peak shapes, resolution, and retention. In addition, the GDILs in the mobile phase and anions adsorbed on the stationary phase also greatly affected the separation. GDILs used as mobile phase additives to separate auxinic herbicides showed high efficiency separation and low damage to HPLC columns, and the developed chromatographic method had excellent linearity, accuracy, precision, and repeatability. The application and mechanism study of GDILs in HPLC would be instructive to determine and separate acid herbicides in food and environmental samples. Graphical abstract As HPLC mobile phase additives, GDILs show high separation performance due to their unique symmetric structures.

[Accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy in breast cancer with three-dimensional reconstruction technique].

OBJECTIVE: To evaluate the accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy (NAC) with three-dimensional (3D) reconstruction technique. METHODS: This was a prospective study. The data of 61 patients with pathologically proven solitary invasive ductal carcinoma (IIA-IIIC) who had received 6 to 8 cycles of NAC from July 2010 to August 2013 was analyzed. All the patients were female, aging from 31 to 70 years with a median of 49 years. Breast specimen after surgery was prepared with part-mount sub-serial section, and residual tumors were microscopically outlined, scanned and registered by Photoshop software. The 3D model of pathological and MRI residual tumors was reconstructed with 3D-DOCTOR software. The longest diameter, maximum cross-section area and volume of the residual tumors determined using 3D MRI were compared with 3D pathological findings, and the associations between MRI and pathology were analyzed by Spearman rank correlation and Bland-Altman analysis. RESULTS: The longest diameter, maximum cross-section area and volume of the residual tumors after NAC measured by MRI and pathology was highly correlated (r=0.942, 0.941, 0.903, all P=0.00). MRI appears to underestimate pathology in the longest diameter, maximum cross-section area, but slightly overestimate in volume, and two methods had a good consistence (MD=0.3 cm, 95% CI: -1.43 to 1.9 cm; MD=1.39 cm², 95% CI: -9.55 to 12.34 cm²; MD=-0.433 cm³, 95% CI: -7.065 to 6.199 cm³). CONCLUSION: 3D MRI reconstruction after NAC could accurately detects the residual tumors after neoadjuvant chemotherapy, and contribute to select patients who received breast conserving therapy after NAC with tumor downstaging.

Magnetic-Controlled Microrobot: Real-Time Detection and Tracking through Deep Learning Approaches.

As one of the most significant research topics in robotics, microrobots hold great promise in biomedicine for applications such as targeted diagnosis, targeted drug delivery, and minimally invasive treatment. This paper proposes an enhanced YOLOv5 (You Only Look Once version 5) microrobot detection and tracking system (MDTS), incorporating a visual tracking algorithm to elevate the precision of small-target detection and tracking. The improved YOLOv5 network structure is used to take magnetic bodies with sizes of 3 mm and 1 mm and a magnetic microrobot with a length of 2 mm as the pretraining targets, and the training weight model is used to obtain the position information and motion information of the microrobot in real time. The experimental results show that the accuracy of the improved network model for magnetic bodies with a size of 3 mm is 95.81%, representing an increase of 2.1%; for magnetic bodies with a size of 1 mm, the accuracy is 91.03%, representing an increase of 1.33%; and for microrobots with a length of 2 mm, the accuracy is 91.7%, representing an increase of 1.5%. The combination of the improved YOLOv5 network model and the vision algorithm can effectively realize the real-time detection and tracking of magnetically controlled microrobots. Finally, 2D and 3D detection and tracking experiments relating to microrobots are designed to verify the robustness and effectiveness of the system, which provides strong support for the operation and control of microrobots in an in vivo environment.

Studies on the airborne bacterial communities and antimicrobial resistance genes in duck houses based on metagenome and PCR analysis.

The threat of antimicrobial resistance (AMR) is on the rise globally, especially with the development of animal husbandry and the increased demand for antibiotics. Livestock and poultry farms, as key sites for prevalence of antibiotic-resistant bacteria (ARB), can spread antimicrobial resistance genes (ARGs) through microbial aerosols and affect public health. In this study, total suspended particulate matter (TSP) and airborne culturable microorganisms were collected from duck houses in Tai'an, Shandong Province, and the bacterial communities and airborne ARGs were analyzed using metagenomics and PCR methods. The results showed that the bacterial communities in the air of duck houses were mainly Actinobacteria, Firmicutes, Proteobactria, Chlamydia, and Bcateroidetes at the phylum level. At the genus level, the air was dominated by Corynebacterium, Jeotgalicoccus, Staphylococcus, Brevibacterium, and Megacoccus, and contained some pathogenic bacteria such as Staphylococcus aureus, Corynebacterium diphtheriae, Klebsiella oxytoca, Acinetobacter baumannii, and Pseudomonas aeruginosa, which were also potential hosts for ARGs. The airborne ARGs were mainly macrolides (10.97%), penicillins (10.73%), cephalosporins (8.91%), streptozotocin (8.91%), and aminoglycosides (8.02%). PCR detected 27 ARGs in airborne culturable microorganisms, and comparative analysis between PCR and the metagenomic data revealed that a total of 9 ARGs were found to the same, including macrolides ErmA, ErmF, tetracyclines tetG, tetX, methicarbamazepines dfrA12, dfrA15, aminoglycosides APH3-VI, ANT2-Ⅰ, and sulfonamides sul2. Moreover, inhalation exposure modeling showed that the workers in duck houses inhaled higher concentrations of ARB, human pathogenic bacteria (HPB) and human pathogenic antibiotic-resistant bacteria (HPARB) than hospital workers. These results provide new insights into airborne microorganisms and ARGs in animal farms and lay the foundation for further study.

Control of Self-Winding Microrobot Using an Electromagnetic Drive System: Integration of Movable Electromagnetic Coil and Permanent Magnet.

Achieving precise control over the motion position and attitude direction of magnetic microrobots remains a challenging task in the realm of microrobotics. To address this challenge, our research team has successfully implemented synchronized control of a microrobot's motion position and attitude direction through the integration of electromagnetic coils and permanent magnets. The whole drive system consists of two components. Firstly, a stepper motor propels the delta structure, altering the position of the end-mounted permanent magnet to induce microrobot movement. Secondly, a programmable DC power supply regulates the current strength in the electromagnetic coil, thereby manipulating the magnetic field direction at the end and influencing the permanent magnet's attitude, guiding the microrobot in attitude adjustments. The microrobot used for performance testing in this study was fabricated by blending E-dent400 photosensitive resin and NdFeB particles, employing a Single-Layer 4D Printing System Using Focused Light. To address the microrobot drive system's capabilities, experiments were conducted in a two-dimensional and three-dimensional track, simulating the morphology of human liver veins. The microrobot exhibited an average speed of 1.3 mm/s (movement error ± 0.5 mm). Experimental results validated the drive system's ability to achieve more precise control over the microrobot's movement position and attitude rotation. The outcomes of this study offer valuable insights for future electromagnetic drive designs and the application of microrobots in the medical field.

Clinical efficacy and biomarker analysis of neoadjuvant camrelizumab plus chemotherapy for early-stage triple-negative breast cancer: a experimental single-arm phase II clinical trial pilot study.

BACKGROUND: Triple-negative breast cancer (TNBC) is associated with a dismal prognosis. Immune checkpoint inhibitors have shown promising antitumor activity in neoadjuvant settings. This single-arm, phase II trial aimed to evaluate the efficacy and safety of camrelizumab plus chemotherapy as the neoadjuvant therapy (NAT) in early TNBC. METHODS: Patients received eight cycles of camrelizumab plus nonplatinum-based chemotherapy. The primary endpoint was total pathological complete response (pCR). Secondary endpoints included the breast pathological complete response (bpCR), adverse events (AEs). Multiomics biomarkers were assessed as exploratory objective. RESULTS: Twenty of 23 TNBC patients receiving NAT underwent surgery, with the total pCR rate of 65% (13/20) and bpCR rate of 70% (14/20). Grade ≥3 treatment-related AEs were observed in 14 (60.9%) patients, with the most common AE being neutropenia (65.2%). Tumor immune microenvironment was analyzed between pCR and non-pCR samples before and after the NAT. Gene expression profiling showed a higher immune infiltration in pCR patients than non-pCR patients in pre-NAT samples. Through establishment of a predictive model for the NAT efficacy, TAP1 and IRF4 were identified as the potential predictive biomarkers for response to the NAT. Gene set enrichment analysis revealed the glycolysis and hypoxia pathways were significantly activated in non-pCR patients before the NAT, and this hypoxia was aggravated after the NAT. CONCLUSION: Camrelizumab plus nonplatinum-based chemotherapy shows a promising pCR rate in early-stage TNBC, with an acceptable safety profile. TAP1 and IRF4 may serve as potential predictive biomarkers for response to the NAT. Aggravated hypoxia and activated glycolysis after the NAT may be associated with the treatment resistance.

The differential diagnosis of lichenoid keratosis and seborrheic keratosis with reflectance confocal microscopy: a preliminary study.

BACKGROUNDS AND OBJECTIVES: Lichenoid keratosis (LK, or lichen planus-like keratosis, LPLK) and seborrheic keratosis (SK) present as similar benign keratotic lesions on cosmetically sensitive area, but require different therapies. Both lesions can be easily differentiated based on histological evaluation of biopsy materials. However, the biopsies may cause scarring and result in hyper-pigmentation, which reduces the compliance of the patients to be treated. In this study, we investigated the role of reflectance confocal microscopy (RCM) in the non-invasive differential diagnosis of LK and SK. PATIENTS AND METHODS: Cases with facial brown patches or plaques suspicious of SK were enrolled in the study. After written informed consent was obtained, the lesions were photographed, imaged by RCM, and then biopsied. The RCM findings were analyzed and correlated with histology results. Evaluation of the RCM pictures and confirmation with histological results were conducted by two independent dermatologists. RESULTS: In total, 10 cases were enrolled in the study. The main characteristics of LK lesions observed by RCM were the disarray of the dermal-epidermal junction (DEJ), and marked inflammatory infiltrates in the superficial dermis; while prominent cerebriform pattern, or elongated cords with bulbous projections without significant inflammation reaction, were the features of SK. Among the 10 cases, clinically suspicious of facial SK, 4 were determined as LK, 6 as SK by RCM imaging, and all the RCM findings were confirmed by histological results. CONCLUSIONS: The RCM features of LK and SK have significant difference, highlighting the important role of RCM in the differential diagnosis of LK and SK, avoiding biopsies and allowing safe treatments.

Exploitation pattern assessment of the Japanese mantis shrimp (Oratosquilla oratoria) resource in the coastal waters of the Shandong Peninsula.

The exploitation pattern of the invertebrate resource (Oratosquilla oratoria) was investigated in the coastal waters of the Shandong Peninsula, along with the seasonal variation in body length structure, spatial distribution in abundance, and interannual stock status. Results showed that the model with only catch data suggested both stocks in the north and south were suffering from extreme fishing pressure without explicit recovery (North: B2019/BMSY = 0.468 and F2019/FMSY = 1.88 in CMSY. South: B2019/BMSY = 0.349 and F2019/FMSY = 2.59 in CMSY). However, the other two assessment models indicated that the northern stock began to gradually recover as the fishing pressure dropped to an appropriate level after the original overfished status (North: B2019/BMSY = 0.738 and F2019/FMSY = 0.882 in AMSY, B2019/BMSY = 0.831 and F2019/FMSY = 0.774 in BSM. South: B2019/BMSY = 0.164 and F2019/FMSY = 1.44 in AMSY, B2019/BMSY = 0.384 and F2019/FMSY = 1.76 in BSM). Overall, the stock status in the north was better than that in the south. This study suggested that spatial exploitation pattern and quarterly differences should be considered in fishery management process.

Risk factors for sentinel lymph node metastasis and validation study of the MSKCC nomogram in breast cancer patients.

OBJECTIVE: To evaluate the risk factors for sentinel lymph node metastasis and validate the value of the Memorial Sloan-Kettering Cancer Center nomogram for the prediction of sentinel lymph node metastasis in breast cancer patients. METHODS: A sentinel lymph node biopsy database containing 1227 consecutive breast cancer patients (416 patients with at least one positive sentinel lymph node) was retrospectively analyzed. The predictive value of the Memorial Sloan-Kettering Cancer Center nomogram was calculated by the trend line and the area under the receiver-operator characteristic curve. Meanwhile, predictors for sentinel lymph node metastasis were also evaluated. RESULTS: Tumor size, histological grade, lymphovascular invasion, mulifocality, estrogen receptor and progesterone receptor status were significant independent predictors for sentinel lymph node metastasis (all P<0.01). The Memorial Sloan-Kettering Cancer Center nomogram presented an area under the receiver-operator characteristic curve value of 0.730. Patients with predictive value<16% had a frequency of sentinel lymph node metastasis of 0.9%. Those with values larger than 70% had a frequency of 96.2%. CONCLUSIONS: The risk factors for sentinel lymph node metastasis in our study were consistent with those in the Memorial Sloan-Kettering Cancer Center nomogram. The Memorial Sloan-Kettering Cancer Center nomogram is a useful tool that could accurately predict the probability of sentinel lymph node metastasis in our breast cancer patients. Axillary surgical staging might be avoided in patients with a predictive value of <16% and axillary lymph node dissection might be done directly in those with a predictive value >70%, while other patients should still accept sentinel lymph node biopsy.

The modified shrinkage classification modes could help to guide breast conserving surgery after neoadjuvant therapy in breast cancer.

Purpose: The traditional shrinkage classification modes might not suitable for guiding breast conserving surgery (BCS) after neoadjuvant therapy (NAT). Aim was to explore the modified shrinkage classification modes to guide BCS after NAT. Methods: From April 2010 to 2018, 104 patients were included. All patients underwent MRI examinations before and after NAT. Residual tumors were removed and divided into more than 30 tissue blocks at 5-mm intervals. After performing routine procedures for paraffin-embedded histology, we made semiserial sections (6-µm thick). The MRI and pathology 3D models were reconstructed with 3D-DOCTOR software. Combined with traditional shrinkage modes and efficacy of NAT, we derived modified shrinkage classification modes which oriented by BCS purpose: modified concentric shrinkage modes (MCSM) and modified non concentric shrinkage modes (MNCSM). The MCSM means the longest diameter of residual tumor was less than 50% and ≤2cm in comparison with the primary tumor before NAT. Other shrinkage modes were classified as MNCSM. Results: According to traditional shrinkage modes, 50 (48.1%) cases were suitable for BCS;while 70 (67.3%) cases were suitable for BCS according to the modified shrinkage modes (p=0.007). The consistency of MRI 3D reconstruction in assessing modified shrinkage classification modes was 93.2%, while it was 61.5% when assessing traditional shrinkage modes. Multivariate analysis showed that primary tumor stage, mammographic malignant calcification, molecular subtypes and nodal down-staging after NAT were independent predictors of modified shrinkage modes (all p<0.05). A nomogram was created based on these four predictors. With a median follow-up time of 77 months, the recurrence/metastasis rate in the MCSM and MNCSM group was 7.1% and 29.4%, respectively. Conclusion: Modified shrinkage classification modes could help to guide the individualized selection of BCS candidates and scope of resection after NAT. MRI 3D reconstruction after NAT could accurately predict modified shrinkage modes and extent of residual tumor.