Molecular subtypes and axillary downstaging surgery after neoadjuvant chemothera-py for breast cancer / 中国肿瘤临床

Objective:To determine the optimal time to perform sentinel lymph node biopsy(SLNB)in patients with clinically node-negative disease and assess clinically node-positive patients who would acquire greater benefits from axillary downstaging surgery af-ter neoadjuvant chemotherapy(NAC).Methods:From October 2010 to November 2017,206 patients with breast cancer who under-went surgery after NAC were included in this retrospective study in Shandong Cancer Hospital Breast Cancer Center.Their clinicopatho-logic data were collected to discuss the correlation between axillary node pathologic complete response(apCR)and different molecu-lar subtypes.Results:Among 206 patients who received NAC,183 patients had clinically node-positive disease.The frequency of apCR after NAC was 33.3%(61/183),which was significantly higher in patients with human epidermal growth factor receptor 2(HER-2)-posi-tive subtype[with targeted therapy,62.1%(18/29);without targeted therapy,34.5%(10/29)]and triple-negative breast cancer(TNBC) (41.0%)(16/39)than in patients with HER-2-negative luminal subtype breast cancer[19.8%(17/86)](P<0.001). Among 23 patients with Cn0 tumors,the rate of positive sentinel lymph nodes after NAC was 26.1%(6/23);this rate was 36.4%(4/11),25.0%(1/4),and 12.5% (1/8)among patients with HER-2-negative luminal subtype breast cancer,TNBC,and HER-2-positive subtype breast cancer,respective-ly.Conclusions:Molecular subtypes could predict the chance of achieving apCR.For patients with clinically node-negative disease,it would be preferable to perform SLNB prior to NAC for patients with HER-2-negative luminal subtype breast cancer.SLNB after NAC for those with TNBC and HER-2-positive subtype breast cancer could decrease the chances of axillary lymph node dissection.For patients with initial clinically node-positive disease converting to clinically node-negative disease after NAC,especially in TNBC and HER-2-posi-tive subtype breast cancer,these patients might benefit more from axillary downstaging surgery after NAC.

Aiyu Capsules or Fufang Banmao Capsules combined with icotinib hydrochloride in the treatment of advanced NSCLC / 中成药

AIM To explore the curative effects,adverse events,effects on immunity function and cost-effectiveness of Aiyu Capsules (Cremastrae pseudobulbus,Solanum lyratum,Angelicae sinensis Radix,etc.) or Fufang Banmao Capsules (Mylabris,Ginseng Radix et Rhizoma,Astragali Radix,etc.) combined with icotinib hydrochloride in the treatment of advanced non-small cell lung carcinoma (NSCLC).METHODS One hundred and sixty patients with advanced NSCLC were randomly divided into three groups.The patients in icotinib hydrochloride group (n =80) took icotinib hydrochloride,125 mg each time,three times a day;the patients in Aiyu Capsules + icotinib hydrochloride group or Fufang Banmao Capsules + icotinib hydrochloride group were treated with Aiyu Capsules (40 cases,three pills each time,three times a day) or Fufang Banmao Capsules (40 cases,one pill each time,three times a day) combined with icotinib hydrochloride (125 mg each time,three times a day),respectively.Curative effects,adverse events,serum tumor markers,dendritic cell subsets and cost-effectiveness among the three groups were compared.RESULTS Eight weeks after the treatment,effective rates in the Aiyu Capsules + icotinib hydrochloride group (82.50％) and Fufang Banmao Capsules + icotinib hydrochloride group (97.5％) were significantly higher than that in the icotinib hydrochloride group (73.5％) (P ＜ 0.05).Six-month survival rates in the icotinib hydrochloride group,Aiyu Capsules + icotinib hydrochloride group and Fufang Banmao Capsules + icotinib hydrochloride group were 93.7％,97.5％ and 97.5％,respectively;one-year survival rates in the three groups were 53.7％,72.5％ and 75.0％,respectively;two-year survival rates in the three groups were 20.0％,37.5％ and 40.0％,respectively.One-year,two-year survival rates in the Aiyu Capsules + icotinib hydrochloride group and Fufang Banmao Capsules + icotinib hydrochloride group were significantly higher than those in the icotinib hydrochloride group (P ＜ 0.05).Myeloid dendritic cell (mDC) subsets' increases (d8week-d1) in the Aiyu Capsules + icotinib hydrochloride group and Fufang Banmao Capsules + icotinib hydrochloride group were significantly higher than that in the icotinib hydrochloride group (P ＜ 0.05).There was no statistical significance in plasmacytoid dendritic cell (pDC) subsets' change among the three groups (P ＞ 0.05).Changes of carcinoembryonic antigen (CEA),cytokeratin-19-fragment (CYFRA21-1),neuron-specific enolase (NSE) in the Aiyu Capsules + icotinib hydrochloride group and Fufang Banmao Capsules + icotinib hydrochloride group were higher than those in the icotinib hydrochloride group (P ＜ 0.05).Treatment costs in the Aiyu Capsules + icotinib hydrochloride group and Fufang Banmao Capsules + icotinib hydrochloride group were significantly lower than that in the icotinib hydrochloride group (P ＜ 0.05).No obvious statistical difference in adverse events was found among the three groups (P ＞ 0.05).CONCLUSION The curative effects and cost-effectiveness of Aiyu Capsules or Fufang Banmao Capsules combined with icotinib hydrochloride are better than those of icotinib hydrochloride alone in the treatment of advanced NSCLC.

Advances in diagnosis and treatment of internal mammary lymph node of breast cancer / 中国肿瘤临床

Internal mammary lymph nodes (IMLN) constitutes approximately 25% of the lymph nodes of the breast. The status of IMLN is one of the prognostic factors in breast cancer patients and essential to regional staging and adjuvant treatment choice. Inter-nal mammary-sentinel lymph node biopsy (IM-SLNB) is deemed a minimally invasive technique for the effective evaluation of IMLN sta-tus and useful in individualized diagnosis and treatment. Injecting radiotracer into glands around the areola through a modified injec-tion technique and at increased injection dose results in the high identification rate of internal mammary sentinel lymph node (IMSLN). Thus, routine IM-SLNB is feasible in clinical practice. Internal mammary lymph drainage pattern is extensively studied, and the accuracy of IM-SLNB guided by modified injection technique is gaining preliminary validation. This review summarizes the progress in diagnosis and treatment of IMLN of breast cancer.

The study of an in-house method for drug resistance genotyping testing on HIV-1 strains prevailing in China / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the amplification rate and the lowestlower detection limit of an in-house HIV-1 Drug resistant (HIVDR) genotyping test.</p><p><b>METHODS</b>A total of 30 plasma samples were selected, which covered all major HIV-1 subtypes predominating prevailing in China (B', CRF07_BC, CRF01 _AE). The viral loads of the 30 selected samples were detected in triplicate by Easy Q method and the average values were taken as the viral loads of the samples. Each sample was diluted to the concentration of > 1000 copies/ml, 401-1000 copies/ml, 101-400 copies/ml, 50-100 copies/ml and < 50 copies/ml with HIV-negative plasma. After extraction of nucleic acids, RT-PCR and nested PCR amplification were performed, the efficiency of amplification of each subtype and the minimum detection limit were determined statistically based on the PCR results.</p><p><b>RESULTS</b>The viral loads of the selected samples ranged from 2.03 x 10(2)-5.92 x 10(4) copies/ml. The sample of 50-1000 copies/ml have a high amplification rate (86%).</p><p><b>CONCLUSION</b>The In-house method for HIV-1 drug resistance genotyping has a high sensitivity with a high successful amplification rate, especially in the samples with low viral load. This method can be used to the detection of drug-resistant virus and to provide scientific data to treatment options for patients.</p>

Feasibility of using dried blood spots to detect HIV drug resistance genotyping / 中华预防医学杂志

<p><b>OBJECTIVE</b>This study aimed at exploring the feasibility of using dried blood spots (DBS) to detect HIV drug resistance genotyping in China by comparing the results of drug resistance from DBS, plasma and whole blood samples.</p><p><b>METHODS</b>Blood samples were collected from 39 AIDS patients from Anhui (10), Yunnan (13), Hunan (6) and Xinjiang (10) provinces and autonomous regions. The HIV strains that infected these patients covered all the major HIV-1 subtypes prevailing in China (B, CRF01_AE, CRF07_BC). HIV drug resistance genotyping assay was performed on DBS as well as on the whole blood and plasma samples from the same patients simultaneously by using an in-house nest RT-PCR method. Drug resistance levels were determined based on Stanford University HIV drug resistance database, and the results from these three types of samples were compared.</p><p><b>RESULTS</b>The percentages of successful amplification of protease and reverse transcriptase regions in the pol gene were 95% (37/39) from DBS, 92% (36/39) from whole blood and 100% (39/39) from plasma samples. The sequences from the three types of samples showed more than 99% identity.86% (31/36) of the DBS samples had the same set of drug resistance mutations as those which were detected from plasma samples. The differences probably resulted from mixed bases.</p><p><b>CONCLUSIONS</b>There was no major difference in detecting HIV drug resistance genotyping among DBS, plasma and whole blood samples. Therefore, DBS is useful for detection of HIV drug resistance genotyping and is particularly valuable in developing countries like China, especially in remote rural regions.</p>

Application of Portable Health Package for the Nurses in Train Evacuation / 医疗卫生装备

Obiective To evaluate the efficacy of health package for the nurse in train evacuation, Methods The self-manufactured new mobile health package for the nurses provides shortcut and completed equipment in various basic nursing care, therapic procedure, condition observation, emergency aid and treatment for nursing staff who performed transportation in train evacuation.Results The potable health package can play an important role in several medical support training and have special mission. Conclusion The health package has mobile applicability and operability, which is an important equipment for successful medical support training.

Comparative study of assessment of pain among medical and nursing staff and cancer patients / 中国实用护理杂志

Objective This study aimed to discuss the different assessment of pain among medical and nursing staff and cancer patients and supply reference for proper analgesic precept for clinical application and nursing measures. Methods We collected the assessment of psychological pain and physiological pain by 55 hospitalization cancer patients, 40 physicians in-charge and 55 nurses in-charge in one week by Johnson inventory. The assessment results were compared and at the same time the relevant problems of the attitude to cancer pain by patients was also investigated. Results Improper recognition existed in cancer pain treatment by most cancer patients. The physiological pain was higher than the psychological pain assessed by both patients and nurses (P<0.05). But the pain assessment by patients was higher than that by the nurses (P<0.05). The assessment of psychological pain was higher than the physiological pain by doctors and both aspects were lower than those by patients, but no statistical difference was seen (P>0.05). The assessment by doctors was more accurate than that by nurses. Conclusions Routine establishment of pain assessment inventory for patients could instruct patients how to record the degree of their pain. We should strengthen the standard training about pain management knowledge and give timely communication with patients' cancer pain.

CD8+ cell noncytotoxic antiviral response (CNAR) to HIV in nosocomial HIV-infected individuals / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the CD8+ cell noncytotoxic antiviral response (CNAR) to HIV in nosocomial HIV infected individuals, and reveal the relationship between the CNAR and CD4+ cell count.</p><p><b>METHOD</b>CD8+ cells from HIV-1 sero-positive individuals were separated by immunomagnetic beads and mixed with CD4+ cells at different CD8 CD4 cell input ratios (2:1, 1:1, 0.5:1 and 0.25:1). Reverse transcriptase (RT) activity of cocultured supernatant was tested and compared with negative control and the suppression rate of HIV-1 replication was measured.</p><p><b>RESULT</b>The average CD8:CD4 cell input ratios to reach 80% suppression of HIV replication in the group with CD4 < 300/microl and CD4 > 300/microl were 2.4:1 and 1.3:1, respectively (P < 0.05).</p><p><b>CONCLUSION</b>CNAR activity in HIV infected individuals is associated with CD4+ cell count. The ability to suppress HIV replication in subjects with CD4 > 300 is stronger than those with CD4 < 300.</p>

Epidemiology, clinical and laboratory characteristics of currently alive HIV-1 infected former blood donors naive to antiretroviral therapy in Anhui Province, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Unregulated commercial blood/plasma collection among farmers occurred between 1992 and 1995 in central China and caused the second major epidemic of human immunodeficiency virus type 1 (HIV-1) infection in China. It is important to characterize HIV-1-infected former blood donors and to study characteristics associated with disease progression for future clinical intervention and vaccine development.</p><p><b>METHODS</b>A cross-sectional study was performed on HIV-1-infected former blood donors (FBDs) and age-matched HIV-seronegative local residents. Demographic, epidemiologic, clinical and key laboratory data were collected from all study participants. Both unadjusted and adjusted multivariate linear regressions were employed to analyze the association of the decrease of CD4(+) T-cell counts with other characteristics.</p><p><b>RESULTS</b>Two hundred and ninety-four HIV-1-infected FBDs and 59 age-matched HIV-seronegative local residents were enrolled in this study. The unregulated blood/plasma collection occurred more than a decade (10.8 - 12.8 years) ago, which caused the rapid spread of HIV-1 infection and the high prevalence of co-infection with hepatitis C virus (HCV, 89.5%); hepatitis B virus (HBV) co-infection was observed in only 11 HIV(+)participants (3.7%). Deterioration in both clinical manifestation and laboratory parameters and increase of viral loads were observed in parallel with the decrease of CD4(+) T-cell counts. The decrease of total lymphocyte counts (P < 0.001) and hemoglobin levels (P < 0.001) and the appearance of dermatosis (P = 0.03) were observed in parallel with the decrease of CD4(+) T-cell counts whereas viral loads (P < 0.001) and CD8(+) T-cell counts (P = 0.01) were inversely associated with CD4(+) T-cell counts.</p><p><b>CONCLUSIONS</b>Co-infection with HCV but not HBV is highly prevalent among HIV-1-infected FBDs. CD4(+) T-cell counts is a reliable indicator for disease progression among FBDs. Total lymphocyte counts, hemoglobin level and appearance of dermatosis were positively associated with CD8(+) T-cell counts and viral loads were inversely associated with the decreased CD4(+) T-cell counts.</p>

Sequence variation in the env V3-V4 region of HIV type 1 predominant subtype B and C strains circulating in China / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To identify genetic variation of HIV-1 predominant subtype B and C strains in China during rapid horizontal transmission and to elucidate the potential relationship between genetic variation and selective pressure.</p><p><b>METHODS</b>After the fragments of HIV-1 env gene were amplified by nested-PCR from the whole blood of 258 HIV-1 infected individuals, PCR products were directly sequenced using ABI 377 DNA sequencer. The sequences covering env V3-V4 region of 72 HIV-1 subtype B(n=37) and C(n=35) strains were selected for phylogenetic analysis. In addition, the ratios of synonymous (Ks) substitutions per nonsynonymous (Ka) substitutions were calculated using DIVERGE.</p><p><b>RESULTS</b>The genetic distances of the V3-V4 region of subtype B strains were higher than that of subtype C strains. Furthermore, sequence analysis revealed that the V4 region was more variable than the V3 region for both subtype B and C strains. What's more, the V3 loop was less variable compared with the V3 upstream region and C3 region for subtype C Ks/Ka ratios of the entire aligned sequence of the two subtypes were below 1 0, with the lowest values found in the V3 region of subtype B strain and the V4 region of subtype C strain.</p><p><b>CONCLUSIONS</b>The majority of variation in both subtypes B and C strains occurred in the V4 rather than the V3 region. It is important that our study found for the first time the V3 loop was more conservative than the V3 upstream region and C3 region for subtype C. Calculations of the Ks/Ka ratios throughout the V3-V4 region demonstrate that significant selective pressures experienced during the rapid horizontal spread of the virus in the Chinese HIV-1 infected population may have directed change in the V3 loop for the subtype B strain and the V4 loop for the subtype C strain. These results will contribute to the policy of AIDS prevention and control and the ongoing development vaccine.</p>

Influence of tamoxifen on the level of cellular proliferation on cultured human pituitary adenoma cells and its mechanism / 中国药理学通报

Aim To investigate the effects of tamoxifen on the proliferation and DNA synthesis of cultured human pituitary adenoma cells and make a further investigation of the mechanism of the inhibitory effect of tamoxifen on the proliferation of pituitary adenoma cells. Methods The techniques of MTT colorimetry, 3H-TdR, flow cytometry, PKC activity detection and cAMP/ cGMP levels detection were used to detect or observe the effects of tamoxifen on proliferation, DNA synthesis, cell cycle, PKC activity and cAMP/ cGMP levels of cultured human pituitary adenoma cells, respectively.Results ①Tamoxifen (0.1,1 and 10 ?mol?L -1) inhibited the proliferation and DNA synthesis of cultured human pituitary adenoma cells in a dose-dependent manner.② tamoxifen (1,10 and 20 ?mol?L -1) increased the ratio of G_1 phase of pituitary adenoma cells, and decreased the ratio of S and G_2 phase markedly;②compared with control, PMA, a PKC activator, increased the activity of membrane and total PKC in human pituitary adenoma cells. However, after a 15-min treatment with tamoxifen (10 ?mol?L -1),a significant reduction of the activity of cytoplasm, membrane and total PKC in human pituitary adenoma cells was observed;③tamoxifen (1 and 10 ?mol?L -1) increased the amount of cAMP in the cytoplasm of human pituitary adenoma cells, but had no effect on that of cGMP. Conclusion These data provide an important clue to explore the molecular mechanisms of the inhibitory effect of tamoxifen on the proliferation of pituitary adenoma cells, and suggest that the modulating effect of tamoxifen on the proliferation of pituitary adenoma cells results from interactions of several cellular signaling pathways.