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Objective:To explore the predictive value of various specific sonographic features on molecular subtypes for invasive breast carcinoma(IBC).Methods:Sonographic and clinicopathological data were retrospectively reviewed for 500 IBC patients who accepted surgical therapy in Fudan University Shanghai Cancer Center from January 2014 to March 2016. All tumors were divided into 5 molecular subtypes. The relationships of sonographic variations associated with the molecular subtypes for IBC were analyzed by univariate and multivariate Logsitic regression analyses.Results:Specific sonographic features for triple-negative subtype included regular shape ( OR=2.06, P=0.018), no spiculated/angular margin ( OR=1.98, P=0.029), posterior acoustic enhancement ( OR=2.26, P=0.005), and no calcification ( OR=2.13, P=0.006). Specific sonographic feature for human epidermal growth factor receptor-2 positive (HER2) subtype was posterior acoustic enhancement ( OR=2.23, P=0.006). Specific sonographic features for Luminal A subtype included spiculated/angular margin ( OR=2.24, P=0.001), posterior acoustic shadow ( OR=1.84, P=0.026), and no calcification ( OR=1.89, P=0.016). There were no specific sonographic features for the Luminal B with HER2 negative subtype, while that for the Luminal B with HER2 positive subtype was calcification ( OR=3.61, P<0.001). However, when used these sonographic features to predict molecular subtypes of breast cancer, the sensitivity values were 8.4%-57.3%, and positive predictive values were 9.5%-53.3%. Conclusions:The variety of sonographic features is associated with molecular subtypes of IBC.However, due to the overlap of sonographic features between different subtypes, molecular subtypes of IBC cannot be predicted by sonographic features.
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Objective To investigate the service needs in relation to the related behavioral characteristics and reproductive health service for women receiving induced abortion in childbearing age in Wenzhou, providing reference for the protection of reproductive health in women of childbearing age. Methods A questionnaire survey was conducted among a total of 1 065 women of childbearing age who received artificial abortion in 12 medical institutions and maternal and child health care institutions in Wenzhou. Results Of the 1 065 women, 456 (42.82%) were under 24 years old, 609 (57.18%) were over 25 years old.815 (76.53%) with high school / technical secondary school degree or below, 250 (23.47%) with college degree or above.448 unmarried (42.07%), 617 married (57.93%).484 (45.45%) of first abortion and 581 (54.55%) of repeated abortion.Among the direct causes of abortion, 244 (54.46%) were not contraception, 382 (61.91%) were contraception failure.There was a significant difference in the direct causes of induced abortion among women with different marital status(χ2＝28.128, P < 0.05).67.51% of the surveyed women hoped that the family planning clinic would provide contraceptive and reproductive health consulting services after abortion. Conclusion Women of childbearing age with induced abortion in Wenzhou have low education level, high rate of repeated abortion, lack of contraceptive knowledge and high demand for contraceptive and reproductive health consulting services.Therefore, it is necessary to improve reproductive health education, popularize contraceptive knowledge, reduce abortion rate and promote reproductive health.
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Objective To explore the ultrasound-guided diffuse optical tomography (DOT) distribution difference and clinical characteristics of T 1-T3 breast carcinoma. Methods Four hundred and forty-seven breast cancer patients with 455 breast lesions were enrolled.The lesion maximal diameter and total hemoglobin concentration(THC) were obtained by ultrasound-guided DOT before breast surgery biopsy.The patients age,body mass index(BMI),and the distances from lesion to skin and nipple were measured,lymph node status were also assessed.According to the 7th Edition of the AJCC Cancer Staging, all tumors were divided into T1( ≤ 2 cm),T2(2 cm < lesion ≤ 5 cm),and T3( > 5 cm) three groups according to maximum diameter on ultrasound.Results Out of 455 breast cancer lesions,148 lesions were stage T1,251 lesions were stage T2,56 lesions were T3.The age,lesion size,lesion THC and the distances between lesions and nipples of breast cancer patients were found that there were significant differences among T1,T2 and T3(all P = 0.000). With T stages increasing,the age of breast cancers patients decreased,the distance between lesions and nipples decreased,the THC increased.THC of breast cancer T 2 [(221.0 ± 56.0)μmol/L] and T3[(233.1 ± 54.0)μmol/L] were significant higher than that of T1 [(181.6 ± 70.4)μmol/L](all P = 0.000).There were all no significant difference for BMI and the distancefrom lesion to skin among different stages T( P > 0.05).With T stages increasing,the ratio of lymph node metastasis increased(T1 26.4%,T2 49.8%,T3 55.4%; P =0.000).Conclusions With breast cancer T stages increasing,T HC increases,the age of the patients decreases,lymph node metastasis rate increases.
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Objective:To develop a stoichiometric relationship between iohexol injection and its refractive index. Methods: Ru-dolph J257 and Mettler Toledo RE40D were adopted to determine the refractive index of iohexol injection produced by different facto-ries. The relationship between the refractive index and the concentration of iohexol determined by potentiometric titration was described as C=2.828R-3.769. Results:The relative deviation of simulated content calculated by the stoichiometric and titration content was less than 2%. Little contribution by excipients could be ignored. Conclusion:The proposed method shows simplicity,rapidity and ac-curacy,which can be applied in the process control and the market supervision of iohexol.
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Objective To investigate the relationship of greyscale ultrasonographic signs and clinical pathological characteristics with axillary lymph node metastasis in invasive breast cancer.Methods Three hundred and thirty-five patients with pathologically confirmed breast cancer were retrospectively analyzed,which categorized into 2 groups,including lymph node metastasis group and lymph node non-metastasis group.The clinical and pathological characteristics included age,primary tumor size,histological grade,and molecular subtypes.The ultrasonographic features were examined including orientation,shape,margin,echo pattern,posterior acoustic feature,and calcification.Chi-Square test and Logistic regression analysis were performed to analyze the relationship of clinical pathological characteristics and greyscale ultrasonographic signs with axillary lymph node metastasis.Results Age (＜45 years),primary tumor size (≥2 cm),histological grade(Ⅲ grade),molecular subtype (Luminal B),and number of margin angulation (＞ 10) contributed to axillary lymph node metastasis in 335 cases,according to univariate analysis (P ＜0.05).Multivariate Logistic regression analysis showed age (OR =0.573,P =0.019),the primary tumor size (OR=2.359,P =0.001),histological grade (OR=0.529,P =0.008),and number of marginangulation (OR =1.889,P =0.031) were risk factors of axillary lymph node metastasis in breast cancer.Conclusions Univariate and multivariate analyses show the correlation between ultrasonographic features and axillary lymph node involvement.Combining with clinical pathological data,it can provide a predictor of axillary lymph node metastasis.
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Objective To study the value of ultrasound-guided fine needle aspiration (FNA) in the diagnosis of axillary lymph node metastasis in breast cancer,and to compared with conventional ultrasound in the diagnosis of metastatic lymph nodes of breast cancer.Methods Five hundred patients were enrolled into study prospectively from our hospital.The set of standard for patients into study:patients were diagnosed by BI-RADS and classified into class 4 or class 5 preoperative,the maximum diameter of the tumor was less than 2 cm,and there was no case of distant metastasis.Ultrasound guided FNA was performed in each case,and the results were compared with conventional ultrasound diagnosis results,using pathological findings as gold standard.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy in the diagnosis of axillary lymph node by conventional ultrasound were 60.6%,67.6%,77.2%,48.7%,and 63.1%,respectively,and by ultrasound-guided FNA were 78%,100%,100%,71.6%,and 85.6%,respectively.There were significant differences between the two diagnostic methods statistically(χ2=113.2,P<0.001).Conclusions Ultrasound-guided FNA can effectively reduce the number of sentinel lymph node biopsy,which displays a certain clinical value.
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Objective To analyze the epidemiological characteristics and trends of accidental death among children under 5 in Wenzhou during the period of 2007—2016, and to provide basis for the intervention program of accidental death in children. Methods The accidental death case of children in Wenzhou during 2007—2016 were collected,then the variation intensity, trend, and cause of death spectrum of accidental death were analyzed. Results The accidental death rate of children under 5 in this city showed a downward trend (P<0.05) during 2007—2016, with 12.38 per ten thousand on average. The accidental death rate of children in rural area was 13.26 per ten thousand, which was higher than 9.99 per ten thousand in urban area (P<0.05) . The accidental death gap between urban and rural children was narrowed down (P<0.05) . The unintentional death rate of floating children was 18.56 per ten thousand, and was higher than that of local children which was 9.44 per ten thousand (P<0.05) . The first cause of accidental death in children under 5 was accidental asphyxia, but drowning (46.38%) was more prominent in the 1-4 year old children. Conclusion In Wenzhou, the first cause of accidental death in children under 5 was accidental asphyxia.The accidental death of migrant children was significantly higher than local children.These characteristics have a good directional effect on future intervention measures.
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Objective To carry out mutation analysis of deafness-associated genes for deaf newborns and their parents, and to estimate the recurrence risk for their parents to have deaf descendants.Methods Suspected cases of inherited deafness were identified by neonatal hearing screening and questionnaires. Genomic DNAs of suspected cases and their parents were extracted from their peripheral blood samples . Common deafness-associated genes(i.e. GJB2,SLC26A4 and 12S rRNA genes)were amplified by polymerase chain reaction(PCR),and those PCR products were sequenced for the mutation analysis.Results From 2013 to 2016, 193 cases of deafness were found in neonatal hearing screening,29 cases of suspected as hereditary deafness were screened,and 17 out of 29 cases were found to have mutations in deafness-associated genes(detection rate:58.62%). GJB2 homozygous mutations were identified in two cases and their parents,and the recurrence risk to have deaf descendants was 100%. Four cases of suspected hereditary deafness had GJB2 homozygous mutations,and their parents were both GJB2 mutation carriers. There was one case with SLC26A4 homozygous mutations,and their parents were both SLC26A4 mutation carrier. Two cases were detected to have GJB2 V371 homozygous mutations,and their parents were both GJB2 V371 mutation carriers. For those seven parents carrying deafness-associated mutations above,the recurrence risk of deafness for their descendants was 25%.Conclusion In addition to hearing screening,the genetic diagnosis of deafness-associated genes is helpful to clarify the cause of suspected neonatal hereditary deafness,and can provide objective reproductive counseling and guidance for those deaf parents or parents with deaf children.
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<p><b>BACKGROUND</b>Tenofovir disoproxil (TDF) is a promising salvage therapy for patients with chronic hepatitis B (CHB) who failed regimens of other nucleoside analogues (NAs). In this study, we aimed to investigate the clinical efficacy and safety of TDF monotherapy in Chinese CHB patients with genotypic resistance.</p><p><b>METHODS</b>A total of 33 CHB patients who had failed treatment with other NAs and had genotypic resistance were switched to TDF monotherapy for 48 weeks. Patients' demographic data (age, sex, history of hepatitis B virus [HBV] therapy), laboratory testing results (hepatitis B e antigen [HBeAg] status, HBV DNA levels, alanine aminotransferase [ALT] levels, serum creatinine, urinary protein, genotypic assay), clinical symptoms, and liver color ultrasound examinations were collected for evaluation at day 0 (baseline) and the 12th, 24th, 36th, and 48th weeks after initiating treatment. Statistical analyses were carried out using rank sum test or rank correlation.</p><p><b>RESULTS</b>With regard to efficacy, the study found that all patients who switched to TDF monotherapy had undetectable HBV DNA levels after 48 weeks. In addition, patients with lower baseline HBV DNA levels realized earlier virological undetectability (rs = 0.39, P = 0.030). ALT levels were normal in 30 of 33 patients (91%). HBeAg negative conversion occurred in 7 of 25 patients (28%), among whom HBeAg seroconversion (12%) and HBeAg seroclearance (16%) occurred. The time of complete virological response was significantly affected by the number of resistance loci (rs = 0.36, P = 0.040). Concerning safety, the study found that no adverse events were observed during the 48 weeks.</p><p><b>CONCLUSION</b>TDF monotherapy is an effective and safe salvage treatment for CHB patients who are resistant to other NAs.</p>
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Adult , Female , Humans , Male , Middle Aged , Anti-HIV Agents , Therapeutic Uses , DNA, Viral , Genetics , Drug Resistance, Viral , Genotype , Hepatitis B virus , Virulence , Hepatitis B, Chronic , Drug Therapy , Prospective Studies , Tenofovir , Therapeutic UsesABSTRACT
Aim to discuss whether the contrast enhanced ultrasound [CEUS] can effectively monitor the efficacy on neoadjuvant chemotherapy of breast cancer or not by analyzing the indicators on chemotherapy CEUS and breast cancer tumor biology, especially tumor microcirculation indicator on animal mode. Human breast cancer cell lines MCF-7 are planted under the skins of nude mice. By simulating clinical neoadjuvant chemotherapy regimen periodically inject CMF [cyclophosphamide, methotrexate and fluorouracil] into the experimental group, and normal saline into the control group. Then detect the data from CEUS and record the parameters: maximum intensity [IMAX], rise time [RT], time to peak [TTP] and mean transit time [mTT]. Execute animal after CEUS, obtain tumor biological indicator and record parameters: micro vessel density [MVD], vascular endothelial growth factor receptors 1/2/3/4 [VEGFR-1/2/3/4] and tumor cells. In the aspect of tumor biological indicator, the experimental group after the first drug delivery: inter- and intra-group comparisons of VEGFR-1/4drop significantly. The experimental group after the second drug delivery: interand intra-group comparisons of MVD, VEGFR-1/3/4drop significantly. In the aspect of parameters on tumor CEUS, the experimental group after the first drug delivery: inter- and intra-group comparisons of IMAX drop significantly. The experimental group after the second drug delivery: inter- and intra-group comparisons of IMAX decrease steeply; while inter-and intra-group comparisons of TTP rise significantly. There are great changes about the intra-group comparisons of the number of tumor cells before and after the experiment. In the process of chemotherapy, it maintains the consistency of the changes of CEUS parameters IMAX and TTP, tumor microcirculation indicators MVD and VEGFR- 1/3/4 and tumor cells. So CEUS has a potential to make an early prediction on the efficacy of neoadjuvant chemotherapy
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Objective To investigate the role of additional post core biopsy ultrasound in clinically node negative breast cancer.Methods Axillary ultrasound was performed before and after breast cancer was diagnosed on core biopsy samples.Post core biopsy ultrasound were performed by radiologists of this department of ultrasound at random.Post-diagnosis ultrasounds were performed by a radiologist with over 20 years of experience for the diagnosis of breast cancer with axi[lary disease.Results were compared to the final axillary pathological result.Results Of the 96 patients,17 were pathology lymph node positive.Post biopsy ultrasound identified 8 of the 17 positive nodes,with a sensitivity 47.1％,specificity 88.6％,positive predictive value of 47.1％,negative predictive value of 88.6％,accuracy of 81.3％.While the diagnosis index of pre-biopsy ultrasound were 47.1 ％,88.6％,47.1％,88.6％,81.3％,respectively.Conclusions Post-biopsy ultrasounds had an increased sensitivity for identifying positive axillary nodes,at the same times,specificity decreased.
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Objective To investigate the value of ultrasound-diffuse optical tomography(US-DOT) in evaluation of the response to neoadjuvant chemotherapy (NCT) in patients with breast cancer.Methods Fifty women with breast cancer confirmed by biopsy-pathology scheduled to undergo NCT were enrolled.US-DOT was performed and the total hemoglobin concentration(HbT) prior to and at the end of NCT.According to the response to treatment in solid tumors,patients were divided into complete response(CR) group,partial response (PR) group,stable disease (SD) group and progressive disease (PD) group.The analysis of variance compared the differences of HbT before and after NCT in each group; Pearson correlation analyzed the relationship between the relative HbT variation and the tumor size changes;Mixedeffects model analyzed the relationship between HbT and tumor size.Results After NCT,CR group had 8 cases,PR group 30 cases,SD group 12 cases and no PD cases.Before and after NCT,the mean relative variations of HbT before and after NCT were-0.525 ± 0.222,-0.328 ± 0.180 and-0.173 ± 0.167 in CR,PR and SD groups,respectively.The differences of HbT before and after NCT were statistically significant in each group (P ＜0.05).There was significant difference among tumor diameter and HbT in CR group and PR group (P ＜0.001);while in the SD group,there was no difference among tumor diameter and HbT (P ＞ 0.05).The change of HbT after NCT showed positive correlation with the change in tumor size (r =0.6).Mixed-effects model also showed that HbT change was associated with tumor size.Conclusions USDOT marker HbT is closely related to tumor size of breast cancer before and after NCT and may be applied to evaluate the response of breast cancer to NCT.