Patient and Care Delays of Breast Cancer in China.

PURPOSE: This study differentiates patient and care delays of breast cancer and explores the related factors as well as the associations with the prognosis in Guangzhou, a southern city of China. METHODS: A cohort of female incident breast cancer patients (n=1,551) was recruited from October 2008 to March 2012 and followed up until January 1, 2016 (n=1,374) in the affiliated hospitals of Sun Yat-sen University. The factors associated with patient and care delays were analyzed with multivariable logistic models. Cox proportional hazards regression models were constructed to estimate the impacts of the delays on the prognosis. RESULTS: There were 40.4% patient delay (≥3 months) and 15.5% care delay (≥1 month). The patient delay, but not the care delay, was significantly related to the clinical stage and consequently worsened the prognosis of breast cancer (hazard ratio, 1.45; 95% confidence interval, 1.09 to 1.91 for progression-free survival). The factors related to an increased patient delay included premenopausal status, history of benign breast disease, and less physical examination. CONCLUSION: Patient delay was the main type of delay in Guangzhou and resulted in higher clinical stage and poor prognosis of breast cancer. Screening for breast cancer among premenopausal women may be an effective way to reduce this delay.

Association of urinary cesium with breast cancer risk.

BACKGROUND: The aim of this study is to examine the association of urinary cesium with breast cancer risk. MATERIALS AND METHODS: We collected survey data and urine specimens from 240 women with incident invasive breast cancer before their treatment and 246 age-matched female controls between October 2009 and July 2010. Urinary concentrations of cesium were determined by inductively coupled plasma mass spectrometry. Interviews were conducted by face-to-face to obtain information on potential breast cancer risk factors. Logistic regression analysis was used to estimate the associations. RESULTS: Creatinine-adjusted levels [median (25th, 75th) ug/g] of cesium in cases and controls were 17.6 (13.1, 24.0) and 19.3 (15.3, 25.7), respectively. After adjustment for potential risk factors, women in the second and highest tertile of cesium showed a decreased risk of breast cancer in a dose-dependent manner as compared with those in the lowest tertile [ORs and 95% CIs: 0.75 (0.46- 1.22) and 0.50 (0.30-0.82), respectively]. This decrease was more evident in women with ER positive or localized clinical stage in an exploratory stratification analysis. CONCLUSIONS: These findings suggest that cesium may have anticancer efficacy and urinary cesium has potential as a biomarker for breast cancer risk assessment.

Biogeochemical transfer and dynamics of iodine in a soil-plant system.

Radioactive iodide (125I) is used as a tracer to investigate the fate and transport of iodine in soil under various leaching conditions as well as the dynamic transfer in a soil-plant (Chinese cabbage) system. Results show that both soils (the paddy soil and the sandy soil) exhibit strong retention capability, with the paddy soil being slightly stronger. Most iodine is retained by soils, especially in the top 10 cm, and the highest concentration occurs at the top most section of the soil columns. Leaching with 1-2 pore volume water does not change this pattern of vertical distributions. Early breakthrough and long tailing are two features observed in the leaching experiments. Because of the relatively low peak concentration, the early breakthrough is really not an environmental concern of contamination to groundwater. The long tailing implies that the retained iodine is undergoing slow but steady release and the soils can provide a low but stable level of mobile iodine after a short period. The enrichment factors of 125I in different plant tissues are ranked as: root > stem > petiole > leaf, and the 125I distribution in the young leaves is obviously higher than that in the old ones. The concentrations of 125I in soil and Chinese cabbage can be simulated with a dual-chamber model very well. The biogeochemical behaviors of iodine in the soil-cabbage system show that cultivating iodized cabbage is an environmentally friendly and effective technique to eliminate iodine deficiency disorders (IDD). Planting vegetables such as cabbage on the 129I-contaminated soil could be a good remediation technique worthy of consideration.

Mechanism of iodine uptake by cabbage: effects of iodine species and where it is stored.

Iodine-enhanced vegetable has been proven to be an effective way to reduce iodine deficiency disorders in many regions. However, the knowledge about what mechanisms control plant uptake of iodine and where iodine is stored in plants is still very limited. A series of controlled experiments, including solution culture, pot planting, and field experiments were carried out to investigate the uptake mechanism of iodine in different forms. A new methodology for observing the iodine distribution within the plant tissues, based on AgI precipitation reaction and transmission electron microscope techniques, has been developed and successfully applied to Chinese cabbage. Results show that iodine uptake by Chinese cabbage was more effective when iodine was in the form of IO(3) (-) than in the form of I(-) if the concentration was low (<0.5 mg L(-1)), but the trend was opposite if iodine concentration was 0.5 mg L(-1) or higher. The uptake was more sensitive to metabolism inhibitor in lower concentration of iodine, which implies that the uptake mechanism transits from active to passive as the iodine concentration increases, especially when the iodine is in the form of IO(3) (-). The inorganic iodine fertilizer provided a quicker supply for plant uptake, but the higher level of iodine was toxic to plant growth. The organic iodine fertilizer (seaweed composite) provided a more sustainable iodine supply for plants. Most of the iodine uptake by the cabbage is intercepted and stored in the fibrins in the root while the iodine that is transported to the above-ground portion (shoots and leaves) is selectively stored in the chloroplasts.

Uptake of different species of iodine by water spinach and its effect to growth.

A hydroponic experiment has been carried out to study the influence of iodine species [iodide (I(-)), iodate (IO(-)(3)), and iodoacetic acid (CH(2)ICOO(-))] and concentrations on iodine uptake by water spinach. Results show that low levels of iodine in the nutrient solution can effectively stimulate the growth of biomass of water spinach. When iodine levels in the nutrient solution are from 0 to 1.0 mg/l, increases in iodine levels can linearly augment iodine uptake rate by the leafy vegetables from all three species of iodine, and the uptake effects are in the following order: CH(2)ICOO(-) >I(-)>IO(-)(3). In addition, linear correlation was observed between iodine content in the roots and shoots of water spinach, and their proportion is 1:1. By uptake of I(-), vitamin C (Vit C) content in water spinach increased, whereas uptake of IO(-)(3) and CH(2)ICOO(-) decreased water spinach Vit C content. Furthermore, through uptake of I(-) and IO(-)(3). The nitrate content in water spinach was increased by different degrees.

Increment of iodine content in vegetable plants by applying iodized fertilizer and the residual characteristics of iodine in soil.

As a new attempt to control iodine deficiency disorder (IDD), we explored a method of iodine supplementation by raising the iodine content in vegetables. When grown in the soil supplemented with iodized fertilizer, the three experimental plant species (cucumber, aubergine, and radish) show increasing iodine levels in both leaf and fruit/rhizome tissues as the iodine content added in soil increases. Excessive iodine added to soil can be toxic to plants, whereas the tolerance limit to excessive iodine varies in the three plant species tested. The migration and volatilization of iodine in soil is correlated with the properties of the soil used. The residual iodine in soil increases as the iodine added to soil increases. The diatomite in the iodized fertilizer helps to increase the durability of the iodized fertilizer. This study potentially provides a safe and organic iodine supplementation method to control IDD.

Release of bioactive active iodine in kelp.

The release process and influencing factors of bioactive iodine of kelp are systemically studied by leaching experiment. The results showed that the bioactive iodine of kelp can be released rapidly and the principal form of iodine in lixivium is I-. There is a dynamic process between the release and absorption of iodine. With the increase of leaching water, the gross amounts of released iodine rise. There also exists a transforming process among I-, IO3- and organic iodine in lixivium.