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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 explore the effect of continuing nursing care based on narrative family therapy for elderly patients with post-stroke cognitive impairment non-dementia (PSCIND). Methods One hundred elderly patients with PSCIND were firstly diagnosed in Sandun Hospital District of Zhejiang Hospital from January to December 2017, the patients discharged between January and June were set as a control group, and the patients discharged between July and December were arranged in an experimental group, 50 cases in each group. Finally, 46 cases in control group and 48 cases in experimental group completed the study. The control group was given routine continuing nursing; while the experimental group was given continuing nursing based on narrative family therapy. The differences of Montreal Cognitive Assessment Scale (MoCA), Modified Barthel Index (MBI) score and Caregiver Load Scale (ZBI) score between the two groups after 12 weeks of intervention were compared. Results There were no statistical significant differences in the scores of MoCA, MBI and ZBI between the two groups before intervention (all P > 0.05). After intervention, the MoCA score of experimental group was significantly higher than that of control group (24.61±2.03 vs. 22.98±2.34, P < 0.05), and the ZBI score was obviously lower than that of control group (34.89±7.12 vs. 38.17±6.53, P < 0.05). But, there was of no statistical significant difference in MBI score between experimental group and control group (54.65±6.32 vs. 52.33±7.36, P < 0.05). Conclusion Narrative family therapy in continuing nursing care can effectively improve the cognitive function of elderly patients with PSCIND and reduce the burden of caregivers.