The Effectiveness and Safety of Acupuncture for Mammary Hyperplasia: A Systematic Review and Meta-Analysis.

Objective: This study aims to systematically evaluate the effectiveness and safety of acupuncture in treating mammary hyperplasia. Methods: A comprehensive search was conducted in various databases, including PubMed, Web of Science, Cochrane Library, Embase, SinoMed, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP Database, from their inception until July 2023. Only randomized controlled trials (RCTs) researching the use of acupuncture for mammary hyperplasia were included. Quality assessment and data analysis were performed using RevMan 5.3 software. Results: Eight RCTs, comprising 573 patients, were included in this analysis. The meta-analysis revealed that in the acupuncture group, the experimental group was better than the control group in improving breast pain, breast lump extent, and the texture of breast lump (P=0.0007, I2=61%; P=0.02, I2=0%; P=0.0002, I2=0%). We found that both could be improved, but after statistical analysis, there was no significant advantage in the acupuncture group compared with the patent Chinese medicine group (p>0.05). Conclusion: Acupuncture appears to be an effective and safe treatment for mammary hyperplasia, providing pain relief and reducing mass volume, texture, and extent. However, the insufficient quality of the available evidence indicates the need for further methodologically rigorous and convincingly designed studies to determine the efficacy and safety of acupuncture in the treatment of breast hyperplasia.

Advances in fibreoptic ductoscopy for the diagnosis and treatment of pathologic papillary overflow.

Fibreoptic mammography is widely recognised as the first screening method for pathologic papillary overflow due to its significant advantages in the diagnosis of ductal dilatation, intraductal papilloma and intraductal carcinoma. The use of fibreoptic ductoscopic excisional biopsy techniques, such as biopsy needles, vacuum negative pressure aspiration, biopsy forceps and grasping baskets, has not been promoted largely due to their existing deficiencies. The imaging effect of fibreoptic ductoscopy compared with electronic ductoscopy is also one of the important factors limiting the progress of microscopic excisional biopsy techniques. Finding a more suitable operating space for electronic fibreoptic ductoscopy and the use of electrosurgical excision biopsy techniques should be the focus of research in view of achieving accurate diagnoses in electronic fibreoptic ductoscopy and microscopic excision biopsy. In this review, the development history, clinical application and existing problems of fibreoptic ductoscopy are reviewed and assessed to provide references for the clinical diagnosis and treatment of pathologic papillary overflow.

Risk Factors for Granulomatous Mastitis and Establishment and Validation of a Clinical Prediction Model (Nomogram).

Background: This study aimed to explore the risk factors and clinical characteristics of granulomatous mastitis (GM) using a case-control study and establish and validate a clinical prediction model (nomogram). Methods: This retrospective case-control study was conducted in three hospitals in China from June 2017 to December 2021. A total of 1634 GM patients and 186 healthy women during the same period were included and randomly divided into the modeling and validation groups in a 7:3 ratio. To identify the independent risk factors of GM, univariate and multivariate logistic analyses were conducted and used to develop a nomogram. The prediction model was internally and externally validated using the Bootstrap technique and validation cohort. The receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the discrimination and calibration of the prediction model. Decision curve analysis (DCA) and clinical impact curve (CIC) were used to evaluate the clinical significance of the model. Results: The average age of GM patients was 33.14 years (mainly 20-40). The incidence was high within five years from delivery and mainly occurred in the unilateral breast. The majority of the patients exhibited local skin alterations, while some also presented with systemic symptoms. On multivariate logistic analysis, age, high prolactin level, sex hormone intake, breast trauma, nipple discharge or invagination, and depression were independent risk factors for GM. The mean area under the curve (AUC) in the modeling and validation groups were 0.899 and 0.889. The internal and external validation demonstrated the model's predictive ability and clinical value. Conclusion: Lactation-related factors are the main risk factors of GM, leading to milk stasis or increased ductal secretion. Meanwhile, hormone disorders could affect the secretion and expansion of mammary ducts. All these factors can obstruct or injure the duct, inducing inflammatory reactions and immune responses. Additionally, blunt trauma, depressed mood, and diet preference can accelerate the process. The nomogram can effectively predict the risk of GM.

AI-Assisted Ultrasound for the Early Diagnosis of Antibody-Negative Autoimmune Thyroiditis.

The prevalence of antibody-negative chronic autoimmune thyroiditis (SN-CAT) is increasing. The early diagnosis of SN-CAT can effectively prevent its further development. Thyroid ultrasound can diagnose autoimmune thyroiditis and predict hypothyroidism. Primary hypothyroidism with a hypoechoic pattern suggested by thyroid ultrasound and negative thyroid serum antibodies is the main basis for the diagnosis of SN-CAT. However, for early SN-CAT, only hypoechoic thyroid changes and serological antibodies are currently available. This study explored how to achieve an accurate and early diagnosis of SN-CAT and prevent the development of SN-CAT combined with hypothyroidism. The diagnosis of a hypoechoic thyroid by artificial intelligence is expected to be a breakthrough in the accurate diagnosis of SN-CAT.

Clinical characteristics and microbiota analysis of 44 patients with granulomatous mastitis.

Introduction: Granulomatous mastitis (GM) is a chronic inflammatory breast disease. In recent years, the role of Corynebacterium in GM onset has received more and more attention. This study aims to detect the dominant bacterium in GM patients and analyze the association between clinical characteristics and infectious factors. Methods: In this study, 88 samples from 44 GM patients, six acute lactation mastitis (ALM) patients, and 25 non-inflammatory breast disease (NIB) patients were divided into a GM pus group, a GM tissue group, an ALM pus group, and a NIB tissue group; then, 16S ribosomal DNA sequencing was used to explore their microbiota. The clinical data of all 44 GM patients were also retrospectively collected and analyzed to determine their relationship with infection. Results: The median age of the 44 GM patients was 33 years, and 88.6% of patients had primary-onset cases, while 11.4% were recurrences; additionally, 89.5% of patients were postpartum and 10.5% were nulliparous. The serum prolactin level was abnormal in nine patients (24.3%). Samples from 15 GM patients (34.1%) had a Corynebacterium abundance of >1% (1.08-80.08%), with eight (53.3%) displaying an abundance of >10%. Corynebacterium was the only genus with significant differences between the GM pus group and the other three groups (p < 0.05). Corynebacterium kroppenstedtii was the predominant Corynebacterium species. Among clinical characteristics, a statistical difference in breast abscess formation was observed according to Corynebacterium abundance in Corynebacterium-positive and- negative patients (p < 0.05). Discussion: This study explored the relationship between Corynebacterium infection and GM, compared the clinical characteristics between Corynebacterium-positive and- negative patients, and provided support for the role of Corynebacterium species-in particular, C. kroppenstedtii-in the pathogenesis of GM. The detection of Corynebacterium can predict GM onset, especially in patients with high prolactin levels or a history of recent lactation.

The clinical significance of complete process management for the quality control of horizontal rotational resection of a breast mass.

Objective: To explore the clinical outcomes of the complete process management of horizontal rotational resection of a breast mass. Methods: A retrospective study was conducted involving 638 patients who underwent horizontal rotational resection of breast tissue in the Department of Thyroid and Breast Surgery of the People's Hospital of China Medical University from August 2018 to August 2020 using the ultrasound Breast Imaging-Reporting and Data System (BI-RADS) classification of 4A and below. These patients were divided into the experimental group and the control group based on whether the surgery had been performed following the order of the complete process management. The time cutoff point for the two groups was June 2019. The propensity score matching method was used to implement 1:1 ratio matching according to age, mass size, location, ultrasound BI-RADS classification, and breast size (measured by basal diameter), and the patients in the two groups were compared for the duration of surgery (the time needed to performed the three-step 3D positioning), postoperative skin hematoma and ecchymosis, postoperative pathological malignancy rate, residual rate of the mass, and satisfaction rate. Results: After 278 pairs were matched, no statistically significant differences were found between the two groups in terms of demographics (P > 0.05). The duration of surgery in the experimental group was significantly shorter compared with the control group (7.90 ± 2.18 min vs. 10.20 ± 5.99 min, respectively; P < 0.05); the satisfaction score in the experimental group (8.33 ± 1.36) was higher compared with the control group (6.48 ± 1.22) (P < 0.05); the malignant and residual rates of mass in the experimental group were lower than those in the control group, i.e., 6 vs. 21 cases (P < 0.05), and 4 vs. 16 cases, respectively (P < 0.05); the incidence of skin hematoma and ecchymosis was lower in the experimental group, i.e., 3 vs. 21 cases (P < 0.05). Conclusion: Complete process management for horizontal rotational resection of a breast mass can shorten the duration of surgery, reduce the residual mass, postoperative bleeding, and postoperative malignancy rates, and improve the breast preservation rate and patient satisfaction. Accordingly, its popularization represents research value.

Horizontal Rotary Cutting Technique for Skin Injury Avoidance in Superficial Benign Breast Masses.

OBJECTIVE: This study aims to investigate the feasibility of the horizontal rotary-cut technique in the removal of superficial benign breast tumors with a ≤1.0 cm distance between the upper margin of the tumor and the skin. PATIENTS AND METHODS: A total of 69 patients with superficial benign breast tumors received horizontal rotary-cut surgery between July 2018 and June 2019 (horizontal group). The rotary cutter groove was in the true lateral position of the tumor and the ultrasonic probe was vertical to the rotary cutter groove. The patients were compared with 33 patients who underwent the traditional vertical rotary-cut surgery between July 2017 and June 2018 (traditional group) regarding the aspects of operation time, intraoperative bleeding volume, postoperative skin ecchymosis, skin damage, and tumor residue. The rotary cutter groove was directly below the tumor and the ultrasonic probe was parallel to the rotary cutter groove in the traditional vertical rotary-cut surgery. RESULTS: The operation time in the horizontal group was significantly shorter than in the traditional group (7.7 ± 1.1 minutes vs 9.5 ± 1.3 minutes, with t = -7.458 and p = 0.000) and there was significantly less skin damage in the horizontal group than in the traditional group (0 cases vs 3 cases, with p = 0.032). The differences in intraoperative bleeding and postoperative skin ecchymosis between the two groups were not statistically significant (6.0 ± 1.3 mL vs 6.5 ± 1.5 mL, with t = -1.853 and p = 0.067; 4 cases vs 2 cases, with χ 2 = 0.003 and p = 0.958). Ninety-seven patients attended follow-ups for 6-30 (16.5 ± 4.5) months. No residues or recurrences were observed under ultrasound reviews in either group. CONCLUSION: In superficial benign breast tumor removal, the horizontal rotary-cut breast technique can help avoid skin injury, shorten the operation time, and reduce tumor residue more effectively compared with the traditional vertical rotary-cut technique. It has certain popularization and application values.

Treatment strategy for chylous leakage after dissection of central lymph nodes in thyroid cancer.

OBJECTIVE: To explore the treatment strategies of chylous leakage after dissection of central lymph nodes in thyroid cancer. METHODS: Patients with chylous leakage after dissection of central lymph nodes in thyroid cancer were recruited in this study. All participants adopted a conservative treatment method of external fixation of neck brace + cotton ball packing and compression bandage + adequate negative pressure drainage and assisted low-fat diet. RESULTS: A total of two patients were included in this study. The results showed that the drainage rate of these two patients was reduced to less than 10 ml after 1-2 days of drainage. The maintenance treatment was continued for 10 days. The drainage volume of the patient did not increase during the three days after returning to normal diet. There was no recurrence of posterior lymphatic leakage. CONCLUSION: External fixation of neck brace + cotton ball packing and compression bandage + adequate negative pressure drainage is important for the treatment of mild to moderate chylotrhea after thyroid cancer surgery which was worthy of clinical application. KEY WORDS: Chylous leakage; Dissection of lymph nodes; Thyroid cancer; External fixation of neck brace; Postoperative complication.

Diagnostic accuracy of the UBC® Rapid Test for bladder cancer: A meta-analysis.

Bladder cancer is one of the most common cancer types globally. The UBC® Rapid Test is a potential novel diagnostic method for bladder cancer, but studies into its accuracy have produced inconsistent results. Thus, the present meta-analysis was conducted in order to determine the overall accuracy of the UBC® Rapid Test in detecting bladder cancer. A comprehensive literature search was conducted using MEDLINE, Embase, Cochrane Library, Web of Science, Chinese WanFang and the China National Knowledge Infrastructure databases for relevant studies. Quality assessment of diagnostic accuracy studies 2 was used to assess the quality of each included study. The diagnostic accuracy of the UBC® Rapid Test was evaluated by pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and the area under the curve (AUC). In addition, Deeks' funnel plot was used to evaluate potential publication bias. Eight studies were included in the quantitative meta-analysis. The results were as follows: Sensitivity 0.59 [95% confidence interval (CI), 0.55-0.62], specificity 0.76 (95% CI, 0.72-0.80), PLR 2.55 (95% CI, 1.75-3.70), NLR 0.56 (95% CI, 0.46-0.67), DOR 4.88 (95% CI, 2.82-8.45) and AUC 0.70 (95% CI, 0.67-0.74). According to the present results, the UBC® rapid test is highly accurate in the diagnosis of bladder cancer, however, further studies with better-designed and larger samples are required in order to support the results of the present study.

Determination of a potential antitumor quassinoid in rat plasma by UPLC-MS/MS and its application in a pharmacokinetic study.

A sensitive UPLC-MS/MS method was developed and validated for the determination of brusatol in rat plasma. Chromatographic separation was carried out on a C18 column using methanol and 10mM ammonium acetate containing 0.1% (v/v) formic acid (55:45, v/v). The lower limit of quantification (LLOQ) was 1.0 ng/mL for brusatol in plasma. The intra- and inter-day precision for the analyte ranged from 3.2% to 9.2% and 1.3% to 7.8%, and the accuracy was between 97.3% and 108.5%. The method was successfully applied in a pharmacokinetic study of brusatol following intravenous injection (0.5, 1.0, and 2.0mg/kg) of brusatol.

Paeoniflorin inhibits proliferation and invasion of breast cancer cells through suppressing Notch-1 signaling pathway.

Paeoniflorin (PF), one of the major active ingredients of Chinese peony, was reported to possess anti-tumor effect. However, the role of PF in breast cancer remains to be clarified. Therefore, in this context, the present study investigated the effects of PF on breast cancer cell proliferation and invasion, as well as the underlying mechanism. Our results found that PF suppressed the proliferation and invasion of breast cancer cells. We further demonstrated that PF down-regulated the expression of Notch-1; in addition, overexpression of Notch-1 reversed PF-inhibited proliferation and invasion, and knockdown of Notch-1 enhanced PF-inhibited proliferation and invasion in breast cancer cells. In conclusion, the present study suggests that PF inhibits proliferation and invasion of breast cancer cells through suppressing Notch-1 signaling pathway. Therefore, PF may represent a chemopreventive and/or therapeutic agent in the prevention of breast cancer.

MiR-217 Promotes Tumor Proliferation in Breast Cancer via Targeting DACH1.

OBJECTIVE: The expression of DACH1 was frequently lost in human breast cancer, which significantly correlated with poor prognosis. Herein, we aim to investigate its underlying mechanisms. METHODS: The expression of miR-217 was detected by Taqman PCR. The mRNA and protein level of DACH1 were investigated by real time PCR and western blot. The dual-luciferase reporter system was used to determine the direct interaction between miR-217 and DACH1. A series of gain&loss of function assays were performed to measure the affects of miR-217 on tumor proliferation and cell cycle distribution. RESULTS: Compared to that in normal breast samples, the expression of miR-217 was significantly upregulated in breast cancer tissues. High level of miR-217 was notably correlated with highly histological grade, the triple negative subtype and advanced tumor stage. Moreover, the expression of miR-217 was negatively correlated with the expression of DACH1. The results of dual-luciferase reporter assay demonstrated that miR-217 directly targets and inhibits the transcriptive activity of DACH1. In vitro, treatment with miR-217 mimics significantly suppressed the proliferation of MCF-7 cells, induced G1 phase arrest and inhibited the expression of cyclin D1; while these effects were significantly reversed by the restoration of DACH1. In MDA-MB-231 cells, treatment with miR-217 inhibitors enhanced the cellular proliferation, promoted cell cycle progression and upregulated the expression of cyclin D1, which were neutralized by the pre-treatment of siRNA-DACH1. In vivo, inhibition of miR-217 significantly suppressed the xenografts growth and downregulated the expression of cyclin D1. CONCLUSION: We found that miR-217 was commonly overexpressed in breast cancer, which could enhance tumor proliferation via promoting cell cycle progression. Moreover, the DACH1 (the cell fate determination factor) was identified as a novel target of miR-217. Our results proposed inhibiting miR-217 to be a potent therapeutic strategy for breast cancer.

Oxymatrine ameliorates L-arginine-induced acute pancreatitis in rats.

The aim of this study was to determine whether oxymatrine has a protective effect against acute pancreatitis (AP) in a rat model of L-arginine-induced AP. AP was induced by two intraperitoneal injections of L-arginine (250 mg/100 g) at a 1-h interval. Oxymatrine (50 mg/kg) was administered every 6 h after the induction of AP. Oxymatrine significantly reduced the plasma amylase, D-lactic acid and tumor necrosis factor alpha concentration, serum diamine oxidase and lipase activity, and pancreatic myeloperoxidase activity, which were increased in AP rats (P < 0.05). In addition, the pancreatic CD45 expression and the expression of claudin-1, but not zonula occludens-1 (ZO-1) and occludin, in the intestinal tissues were significantly reduced after the induction of AP. However, oxymatrine increased the expression of claudin-1 and CD45, but did not alter the expression of ZO-1 and occludin. In conclusion, our results demonstrated that oxymatrine is potentially capably of protecting against L-arginine-induced AP and attenuating AP-associated intestinal barrier injury by up-regulation of claudin-1.