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Currently,there are still obstacles for patients’ right of self-determination in medical decision-making. By sorting out its historical origins,this paper found that the reasons for the current situation mainly include the influence of familial culture and medical paternalism,as well as the constraints of the behavioral capacity system and the guardianship systems. In this context,this paper criticized the view that “the key to enjoying decision-making power is rationality”,and called for a return to the concept of patient autonomy,so as to achieve a balance between agency decision-making power of others and the special intervention rights of doctors. The legal system for resolving conflicts can be constructed by replacing behavioral capacity with medical decision-making ability,requiring the evaluation of medical decision-making ability based on actual conditions,establishing a pre-medical instruction system,and clarifying the boundaries of medical special intervention rights.
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Objective:To analyze the effects of pelvic floor muscle biofeedback electrical stimulation (PEMS) combined with pelvic floor muscle training (PFMT) and PFMT alone on mild to moderate stress urinary incontinence (SUI) after delivery.Methods:This retrospective study involved 1 087 postpartum women with mild or moderate SUI who were admitted to the Affiliated Hospital of Jining Medical University from January 2017 to January 2021. According to the treatment approaches, they were divided into two groups: the PMES+PFMT group ( n=504) and the PFMT group ( n=583). Chi-square test, independent sample t-test and rank sum test were used to compare the objective indicators (pelvic floor muscle strength test, vaginal dynamic pressure value test, 1-h pad test) and subjective indicators [incontinence impact questionnaire short form (IIQ-7), incontinence questionnaire-urinary incontinence short form (ICI-Q-SF), pelvic organ prolapse/urinary incontinence sexual function questionnaire (PISQ-12)] before, immediate and three months after treatment between the two groups. Results:There was no significant difference between the two groups in the values of vaginal dynamic pressure before treatment, 1-h pad test results and subjective indicators (all P>0.05). Comparison within groups: Indicators were improved in both groups immediate and three months after treatment compared with before treatment, including strength of type Ⅰ muscle [PMES+PFMT group: grade 4 and 5 (normal): 43.5% (219/504) and 42.1% (212/504) vs 1.2% (6/504), χ 2=864.27 and 861.46; PFMT group: grade 4 and 5:19.2% (112/583) and 20.1% (117/583) vs 1.5% (9/583), χ 2=1 148.26 and 1 038.29] and class Ⅱ muscle strength [PMES+PFMT group: 48.4% (244/504) and 50.8% (256/504) vs 4.8% (24/504), χ 2=862.96 and 819.24; PFMT group: 37.4% (218/583) and 38.9% (227/583) vs 5.0% (29/583), χ 2=1 029.47 and 998.54; all P < 0.05].Vaginal dynamic pressure increased [PMES+PFMT group: (89.3±5.4) and (82.2±4.6) vs (67.5±12.7) cmH 2O (1 cmH 2O=0.098 kPa), t=802.13 and 845.54; PFMT group:(80.2±4.3) and (78.6±4.5) vs (66.9±14.2) cmH 2O, t=288.37 and 244.94], and 1-hour urine leakage reduced [PMES+PFMT group: 2.0 g (2.0-3.0 g) and 2.0 g (1.0-3.0 g) vs 6.0 g (5.0-6.0 g), Z=825.39 and 802.13; PFMT group: 4.0 g (3.0-5.0 g) and 3.0 g (3.0-4.0 g) vs 5.0 g (4.0-6.0 g), Z=836.34 and 811.25], and IIQ-7 scores [PMES+PFMT group: scores of 3 (2-4) and 4 (3-4) vs 8 (7-9), Z=959.52 and 825.87; PFMT group: 5 (4-5) and 5 (4-6) vs 8 (7-10), Z=916.27 and 903.18], and ICI-Q-SF score [PMES+PFMT group: 3.5 (3-4) and 4 (3-5) vs 10 (9-12), Z=952.79 and 924.94; PFMT group: 6 (4-7) and 6 (5-7) vs 11 (10-12), Z=1 049.89 and 998.15], and PISQ-12 score [PMES+PFMT group: 10 (7-12) and 9 (7-12) vs 21 (17-24), Z=862.55 and 887.17; PFMT group: 13 (11-16) and 14 (12-16) vs 22 (18-25), Z=1 026.73 and 934.86, all P<0.05) decreased. Compared with the PFMT group, the above indexes were all better in the PMES+PFMT group (all P<0.05). Conclusion:PFMT alone or in combination with PMES can both enhance pelvic floor muscle strength, increase vaginal dynamic pressure, alleviate urine leakage and improve the quality of life and PMES+PFMT is better and more effective.
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Objective:To investigate the prognostic significance of anemia in elderly patients with stable coronary artery disease treated by percutaneous coronary intervention(PCI).Methods:In this retrospective cohort study, 180 patients with stable coronary artery disease aged ≥60 years undergone percutaneous coronary intervention and with complete clinical data, admitted to Nanjing Meishan Hospital between June 2016 and December 2017, were selected.Baseline clinical data of the patients were collected, including hemoglobin, C-reactive protein, lipids, fasting glucose, glycated hemoglobin, blood creatinine, and left ventricular ejection fraction on cardiac color ultrasound.The endpoints of the follow-up included major adverse cardiac events(MACE), such as all-cause death, non-fatal myocardial infarction, and non-fatal stroke.According to the hemoglobin level, participants were divided into an anemia group(n=32)and a non-anemia group(n=148). Clinical data of the two groups were compared, and the Kaplan-Meier method and multivariate analysis with the Cox regression method were used to evaluate the effect of anemia on the occurrence of MACE in elderly patients with stable coronary artery disease treated by PCI.Results:The median duration of the follow-up of the 180 patients was 702.5 days and MACE occurred in 27(15.0%). Compared with the non-anemia group, the anemia group had a higher age, C-reactive protein level and MACE ratio, lower levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol and the glomerular filtration rate, and higher proportions of patients with smoking history and patients with dyslipidemia( P<0.05). Kaplan-Meier curves suggested that the incidence of MACE in the anemia group was higher than that in the non-anemia group[37.5%(12/32) vs.10.1%(15/148), P<0.05]. Multivariate analysis with the Cox regression method showed that the risk of MACE in the anemia group was 2.91 times higher than that in the non-anemia group( HR=2.91, 95% CI: 1.13-7.48, P<0.05). Conclusions:Anemia is an independent predictor of MACE in elderly patients with stable coronary artery disease after PCI.
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The continuous emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants poses challenges to the effectiveness of neutralizing antibodies. Rational design of antibody cocktails is a realizable approach addressing viral immune evasion. However, evaluating the breadth of antibody cocktails is essential for understanding the development potential. Here, based on a replication competent vesicular stomatitis virus model that incorporates the spike of SARS-CoV-2 (VSV-SARS-CoV-2), we evaluated the breadth of a number of antibody cocktails consisting of monoclonal antibodies and bispecific antibodies by long-term passaging the virus in the presence of the cocktails. Results from over two-month passaging of the virus showed that 9E12+10D4+2G1 and 7B9-9D11+2G1 from these cocktails were highly resistant to random mutation, and there was no breakthrough after 30 rounds of passaging. As a control, antibody REGN10933 was broken through in the third passage. Next generation sequencing was performed and several critical mutations related to viral evasion were identified. These mutations caused a decrease in neutralization efficiency, but the reduced replication rate and ACE2 susceptibility of the mutant virus suggested that they might not have the potential to become epidemic strains. The 9E12+10D4+2G1 and 7B9-9D11+2G1 cocktails that picked from the VSV-SARS-CoV-2 system efficiently neutralized all current variants of concern and variants of interest including the most recent variants Delta and Omicron, as well as SARS-CoV-1. Our results highlight the feasibility of using the VSV-SARS-CoV-2 system to develop SARS-CoV-2 antibody cocktails and provide a reference for the clinical selection of therapeutic strategies to address the mutational escape of SARS-CoV-2.
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Numerous mutations in the spike protein of SARS-CoV-2 B.1.1.529 Omicron variant pose a crisis for antibody-based immunotherapies. The efficacy of emergency use authorized (EUA) antibodies that developed in early SARS-CoV-2 pandemic seems to be in flounder. We tested the Omicron neutralization efficacy of an early B cell antibody repertoire as well as several EUA antibodies in pseudovirus and authentic virus systems. More than half of the antibodies in the repertoire that showed good activity against WA1/2020 previously had completely lost neutralizing activity against Omicron, while antibody 8G3 displayed non-regressive activity. EUA antibodies Etesevimab, Casirivimab, Imdevimab and Bamlanivimab were entirely desensitized by Omicron. Only Sotrovimab targeting the non-ACE2 overlap epitope showed a dramatic decrease activity. Antibody 8G3 efficiently neutralized Omicron in pseudovirus and authentic virus systems. The in vivo results showed that Omicron virus was less virulent than the WA1/2020 strain, but still caused deterioration of health and even death in mice. Treatment with 8G3 quickly cleared virus load of mice. Antibody 8G3 also showed excellent activity against other variants of concern (VOCs), especially more efficient against authentic Delta plus virus. Collectively, our results suggest that neutralizing antibodies with breadth remains broad neutralizing activity in tackling SARS-CoV-2 infection despite the universal evasion from EUA antibodies by Omicron variant.
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Emerging SARS-CoV-2 variants are threatening the efficacy of antibody therapies. Combination treatments including ACE2-Fc have been developed to overcome the evasion of neutralizing antibodies (NAbs) in individual cases. Here we conducted a comprehensive evaluation of this strategy by combining ACE2-Fc with NAbs of diverse epitopes on the RBD. NAb+ACE2-Fc combinations efficiently neutralized HIV-based pseudovirus carrying the spike protein of the Delta or Omicron variants, achieving a balance between efficacy and breadth. In an antibody escape assay using replication-competent VSV-SARS-CoV-2-S, all the combinations had no escape after fifteen passages. By comparison, all the NAbs without combo with ACE2-Fc had escaped within six passages. Further, the VSV-S variants escaped from NAbs were neutralized by ACE2-Fc, revealing the mechanism of NAb+ACE2-Fc combinations survived after fifteen passages. We finally examined ACE2-Fc neutralization against pseudovirus variants that were resistant to the therapeutic antibodies currently in clinic. Our results suggest ACE2-Fc is a universal combination partner to combat SARS-CoV-2 variants including Delta and Omicron.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) continue to wreak havoc across the globe. Higher transmissibility and immunologic resistance of VOCs bring unprecedented challenges to epidemic extinguishment. Here we describe a monoclonal antibody, 2G1, that neutralizes all current VOCs and has surprising tolerance to mutations adjacent to or within its interaction epitope. Cryo-electron microscopy structure showed that 2G1 bound to the tip of receptor binding domain (RBD) of spike protein with small contact interface but strong hydrophobic effect, which resulted in nanomolar to sub-nanomolar affinities to spike proteins. The epitope of 2G1 on RBD partially overlaps with ACE2 interface, which gives 2G1 ability to block interaction between RBD and ACE2. The narrow binding epitope but high affinity bestow outstanding therapeutic efficacy upon 2G1 that neutralized VOCs with sub-nanomolar IC50 in vitro. In SARS-CoV-2 and Beta- and Delta-variant-challenged transgenic mice and rhesus macaque models, 2G1 protected animals from clinical illness and eliminated viral burden, without serious impact to animal safety. Mutagenesis experiments suggest that 2G1 could be potentially capable of dealing with emerging SARS-CoV-2 variants in future. This report characterized the therapeutic antibodies specific to the tip of spike against SARS-CoV-2 variants and highlights the potential clinical applications as well as for developing vaccine and cocktail therapy.
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Older patients, especially those with malignancy, may have an increased risk of pulmonary embolism (PE). However, few studies have evaluated the clinical characteristics and prognosis of older patients. We evaluated the clinical characteristics, prognosis, and risk factors in older patients with lung cancer complicated with PE. This was a single-center, prospective cohort study. Older patients (≥65 years) with lung cancer admitted in Beijing Hospital from January 2006 to December 2016 were enrolled. The patients were divided into two groups according to the presence of PE using propensity score matching (PSM). After PSM, one hundred and six patients (53 per group) with an average age of (77.3 ± 10.9) years were enrolled. Adenocarcinoma was the most common histology in patients with PE (52.8%, n = 28), and most lung cancer patients were in stages III and IV (59.4%, n = 63). Patients with PE were stratified to low risk (52.8%, n = 28), intermediate-low risk (24.5%, n = 13), intermediate-high risk (15.1%, n = 8), high-risk (7.5%, n = 4) subgroups. Most PE patients presented with dyspnea (75.5%), and the majority of patients (86.8%, n = 46) developed PE within 3 months after the diagnosis of cancer. The median follow-up time was 23.7 months (12.0-62.0 months), and 7 patients (6.6%) were lost to follow-up. During the follow-up period, 92 patients (86.8%) died, including 8 cases (8.7%) of PE-related death, 73 (79.3%) of tumor death, and 11 (11.9%) of unknown cause. There were significant differences in all-cause mortality (94.3% vs. 83.0%) and PE-related mortality (15.1% vs. 0) between the PE and control groups, but the rate of tumor-related mortality (75.5% vs. 66.0%) was comparable between the groups. Among the 92 patients who died, the mortality rates at 3, 6, 12, and > 12 months after tumor diagnosis were 33.0% (33/106), 57.5% (61/106), 78.3% (83/106), and 89.6% (95/106), respectively. Kaplan-Meier survival analysis showed that the median overall survival time was significantly different between the PE and the control groups (4.3 vs. 9.2 months, P = 0.0015). Multivariate stepwise logistic regression analysis showed that age ≥ 77 years (OR = 2.58, 95%CI: 1.66-4.01), clinical stage III-IV (OR = 2.21, 95%CI: 1.03-4.74), adenocarcinoma (OR = 3.24, 95%CI: 1.75-6.00), high D-dimer (≥600 mg/L) (OR = 2.73, 95%CI: 1.25-5.96), and low partial pressure of oxygen (PaO2; <75 mmHg) (OR = 2.85, 95%CI: 1.74-4.67) were independent risk factors for PE in older patients with lung cancer. Older patients with lung cancer and PE often have poor prognosis. Advanced age, clinical stage III-IV, adenocarcinoma, high D-dimer level, and low PaO2 are independent risk factors for PE.
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Neoplasias Pulmonares/mortalidad , Embolia Pulmonar/etiología , Embolia Pulmonar/fisiopatología , Anciano , Anciano de 80 o más Años , China/epidemiología , Estudios de Cohortes , Comorbilidad , Femenino , Humanos , Estimación de Kaplan-Meier , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/fisiopatología , Masculino , Pronóstico , Puntaje de Propensión , Estudios Prospectivos , Factores de Riesgo , Análisis de SupervivenciaRESUMEN
Objective:To investigate the mammography, ultrasound and MRI features of breast ductal carcinoma in situ within papillomas (DCIS-WP) and ductal carcinoma in situ in general (DCIS-IG), and to select the appropriate screening methods for breast cancer.Methods:A retrospective analysis of 134 patients with DCIS-WP and DCIS-IG confirmed by pathology from January 2015 to October 2018 was conducted, including 40 patients with DCIS-WP and 94 patients with DCIS-IG. Mammography, ultrasound and MRI images were analyzed based on BI-RADS criteria, to evaluate the missed diagnosis rate and accuracy rate of three imaging methods, and the consistency of preoperative puncture, intraoperative frozen section and postoperative paraffin section was also observed. Qualitative data were compared using the χ 2 test or Fisher′s exact test. Results:The X-ray missed diagnosis rate of DCIS-WP group and DCIS-IG group was 42.50%(17/40) and 5.32%(5/94), respectively, while the diagnostic accuracy rate was 22.50%(9/40) and 77.66%(73/94) respectively. The difference between the two groups was statistically significant (χ2=28.268, 35.952, P<0.001). In DCIS-WP group and DCIS-IG group, there were 8 and 2 cases with multiple hypoechoic nodules in the lesions, the difference was statistically significant (χ2=20.819, P<0.001); the missed diagnosis rate was 0 and 24.47%(23/94), the difference was statistically significant ( P<0.05). On MRI, there were 24 cases and 15 cases of DCIS-WP group and DCIS-IG group with the signs of catheter dilation, 21 cases and 16 cases with multiple papillomas background, 15 cases and 12 cases with sparse internal ring manifestations, 19 cases and 13 cases with different sizes, respectively. The difference between the two groups was statistically significant (χ2=26.378, 17.671, 8.524, 14.530, P<0.05). In DCIS-WP group and DCIS-IG group, 12 cases and 82 cases had the same diagnosis of preoperative puncture, intraoperative frozen pathology and postoperative paraffin pathology respectively, and the difference between the two groups was statistically significant (χ2=44.165, P<0.001). Conclusions:The features of DCIS-WP are different from those of DCIS-IG on mammography and ultrasound. DCIS-WP is likely to be missed on mammography as there is less calcification, while it is easier to be detected by ultrasound. MRI has good diagnostic efficacy for both types of DCIS and is helpful in differentiating them.
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Objective: To establish a prediction model for the distant metastasis of breast cancer based on qualitative magnetic reso-nance imaging (MRI) parameters. Methods: A retrospective analysis of 3,032 patients with breast MRI from January 2011 to Decem-ber 2016 in Tianjin Medical University Cancer Institute and Hospital was conducted. After the confirmation of invasive breast cancer, the subjects were divided in 2 groups: metastasis and metastasis-free. A total of 93 patients were included in the metastasis group, and 186 patients without the presence of distant metastasis in the metastasis-free group. We analyzed the correlation between breast cancer molecular subtypes and distant metastasis in the metastasis group. Univariate and Logistic regression analyses of qualitative MRI features were performed for the groups. Subsequently, we used the results to establish prediction models. Results: The results showed that hormone receptor-positive tumors (Luminal type) had a greater tendency to develop bone metastasis in the metastasis group. Triple-negative tumors showed a greater tendency to develop lung metastasis. Human epidermal growth factor receptor 2 gene overexpression cases were more likely to develop liver metastasis. The results of the univariate analysis showed that the type of le-sion, multifocality or multicentricity of the cancer, T1-weighted signal uniformity, T2-weighted signal uniformity, and tumor size were statistically different between the groups (P<0.05). The results of the logistic regression analysis showed that the type of lesion, multi-focality or multicentricity of the cancer, T2-weighted signal uniformity, and tumor size were independent predictors of distant metasta-sis. Based on select independent predictors, we established a prediction model for the distant visceral metastasis of breast cancer. The accuracy, area under the curve, sensitivity, and specificity of the model were 82.8%, 0.801, 85.7%, and 75.0%, respectively. Conclu-sions: The prediction model based on the clinical pathology and MRI features established in this study can predict the distant metasta-sis of breast cancer.
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Objective To investigate the magnetic resonance imaging (MRI) features and differential diagnosis of axillary schwannomas, and analyze the causes of misdiagnosis. Methods A retrospective study from October 2014 to October 2017 was performed in 5 patients with axillary schwannomas, confirmed by surgery and pathology, in whom clinically suspected axillary metastases have been diagnosed. All the patients underwent breast MRI to summarize the key points of diagnosis and differential diagnosis. Results Five tumors located in neurovascular bundles extending along the brachial plexus nerve distribution. The tumors presented as single, spindle or ovoid masses, well-circumscribed margins in 4 cases, entering and exiting nerve signs in 5 cases, the split fat sign in 4 cases, vascular compressed sign in 5 cases, and target sign in 1 case. The tumors were isointense or slight hypointense on T1WI compared to the adjacent muscle. Three tumors manifested heterogeneous slight hyperintense, 1 tumor was slight hyperintense, and the target sign was seen in 1 tumor on T2WI. Diffusion-weighted image was heterogeneous hyper or slightly hyper-intense. When b=500 and 1 000 s/mm2, the apparent diffusion coefficient (ADC) was (1.40 - 2.23) × 10 -3mm2/s and (1.31 -2.94) × 10-3mm2/s respectively. All the 5 tumors manifested persistent enhancement on dynamic contrast-enhanced MRI (DCE-MRI). Three tumors were heterogeneously enhanced, and 2 tumors were circularly enhanced. Conclusions Axillary schwannomas has certain characteristics which can be helpful for the identification of metastatic lymph nodes.
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Objective This study examined the prevalence of underweight and its related risk factors of community-dwelling patients with schizophrenia. Methods Five hundred and three community-dwelling patients with schizophrenia and 323 healthy controls were recruited in a cross-sectional study. Body mass index less than 18.5 was defined as underweight. Their demographic and clinical data including anthropometric data, plasma glucose and lipid parameters were collected. The Positive and Negative Syndrome Scale (PANSS) was used to assess patients' psychopathology. Results The prevalence of underweight was 9.9% (50/503) in schizophrenia patients versus 1.5% (5/323) in the control group ( P<0.01). Further logistic regression analysis showed that male ( OR=2.43, 95%CI:1.74~3.39), smoking behavior (OR=1.50, 95%CI: 1.21~1.86), hospitalization times (OR=1.18, 95% CI: 1.06~1.31), PANSS negative score (OR=1.09, 95% CI: 1.04~1.14) were significant predictors for underweight (all P<0.05). Conclusion The prevalence of underweight is higher in Chinese patients with schizophrenia than in the general population. Some demographic and clinical variables are risk factors for underweight in schizophrenia.
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Objective To explore the prevalence,socio-demographic and clinical characteristics of deficit schizophrenia in Chinese community-dwelling patients with schizophrenia. Methods Five hundred and three community-dwelling patients with schizophrenia were recruited in a cross-sectional study in Yuhua-tai District of Nanjing,and deficit schizophrenia was confirmed by Chinese version of the Schedule for the Deficit Syndrome (SDS). Their socio-demographic and clinical characteristics were collected. All patients' psychopathology was assessed by Positive and Negative Syndrome Scale (PANSS). Results The current prevalence of community-dwelling patients with deficit schizophrenia was 0. 67‰. Deficit schizophrenia had significantly higher hospitalizations((2. 4±1. 3)times,(1. 9±0. 9)times),PANSS negative scores((28. 4± 8. 1),(17. 7±6. 3)),PANSS total score((96. 5±17. 3),(87. 3±18. 1)) than non-deficit schizophrenia(all P<0. 05),while non-deficit schizophrenia had higher currently smoking rate,positive scores,marriage per-centage and age of onset( all P<0. 05) . Further multiple logistic regression analysis indicated that male sex, age of onset,smoking and negative PANSS score were independently associated with deficit schizophrenia. Conclusion The study showed that deficit schizophrenia is very common in Chinese psychiatric outpatients. The results partially support deficit schizophrenia as an independent subtype of schizophrenia.
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Objective To study the features of mucinous carcinoma and myxoidfibroadenoma of the breast on MRI.Methods Fourty patients with pure mucinous carcinoma and myxoidfibroadenoma confirmed by surgical pathology who underwent breast MRI from January 2010 to May 2017 in Tianjin Medical University Cancer Institute and Hospital were analyzed retrospectively, including 26 patients with mucinous carcinoma and 14 patients with myxoidfibroadenoma. By use of the Breast Imaging Reporting and Data System (BI-RADS) lexicon, an analysis of the shape, margin, infiltration to adjacent tissues, the lesion location, signal intensity in the T1WI and fat-suppressed T2WI, dark internal septation, the pattern of time-signal intensity curve (TIC),rim enhancement, delayed internal enhancement, the DWI signal and ADC values was performed. Qualitative data and quantitative data were compared with χ2test and independent sample t test respectively. Results There were significant differences in the margin,dark internal septation,the lesion location, rim enhancement and delayed internal enhancement between mucinous carcinoma and myxoidfibroadenoma(P<0.05). The shape, signal intensity in the T1WI and fat-suppressed T2WI,infiltration to adjacent tissues, the pattern of TIC, the DWI signal and ADC values were not statistically significant between the two groups(P>0.05).Conclusion The combination of irregular margin, less frequent dark internal septation, rim enhancement in the early phase, delayed heterogeneous enhancement and the lesion location where was in the shallow layer of fibro-glandular tissue were significant findings for differentiation between mucinous carcinoma and myxoidfibroadenoma.
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Objective To characterize the imaging features of fibroblastic and (or) myofibroblastic benign tumors. Methods The imaging manifestations were analyzed in fourteen patients with fibroblastic and (or) myofibroblastic benign tumors of the breast area confirmed by histopathology from July, 2010 to July, 2017. Independent-samples t test was performed to compare ADC values between lesions and normal breast tissue. Results Thirteen cases were adhered to superficial facia of breasts and 1 case was located in the pectoralis. Five lesions were presented as a mass on MRI, 9 lesions were presented as a non-mass. Twelve cases showed low signal intensity on T1WI, 8 cases showed high signal intensity and 4 cases showed moderately or slightly high signal intensity on T2WI. TIC analysis showed that 10 cases had typeⅠenhancement and 4 cases had typeⅢenhancement. There was no difference between mean ADC values of lesions and normal breast tissue (P>0.05). All the cases showed hypoechoic and spiculated margins on ultrasound. Twelve cases were hypovascular ones. Twelve cases underwent mammography. Five cases were presented as a mass and 7 cases were presented as asymmetric. These cases showed equal density without suspicious calcifications. Conclusion The location, MRI, ultrasound and mammography manifestations of fibroblastic and (or) myofibroblastic benign tumors have some characteristics and these imaging findings may help to establish an accurate preoperative diagnosis.
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Objective To develop and validate a radiomics predictive model based on mammogram for preoperative predicting triple-negative breast cancer (TNBC) or non-triple-negative breast cancer (NTNBC). Methods We retrospectively analyzed 459 Chinese women who were diagnosed with invasive breast cancer (confirmed by pathology) during August 2015 to November 2015. Our cohort included 34 TNBC and random selected 102 NTNBC cases. Regions of interest (ROIs) were manually selected from craniocaudal and mediolateral oblique mammograms by radiologists through manual lesion segmentation, and 43 radiomics features were evaluated. Craniocaudal (CC) single-view, mediolateral oblique (MLO) single-view and CC and MLO double-view classification model were constructed respectively. Classification performance was evaluated by the area under receiver operating characteristic curve (AUC), accuracy, sensitivity and specificity. Kruskal-Walls U test and t test were used to compare the radiomics features between TNBC and UTNBC. Results The model that used the combination of both the CC and MLO view images achieved the overall best performance than using either of the two views alone, yielding an AUC of 0.791, accuracy of 0.798, sensitivity of 0.776 and specificity of 0.806 for TNBC comparing with NTNBC. Three features were selected by the model (gray scale span and inverse different moment for CC, roundness for MLO) showed a statistical significance (P<0.05) and AUC>0.6 in the subtype classification. Conclusion This research constructed model based on mammograms classification model can effectively distinguish between TNBC and NTNBC. This model has potential value for breast cancer molecular subtype classification and clinical treatment.
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Based on literature research and data analysis, the current development situations of the large comprehensive hospitals in the underdeveloped area were analyzed objectively.In addition, with the practical situation of Guangxi, the article did not only elaborate the necessity of establishing a research oriented hospital, but also the way for the construction of research oriented hospital in the underdeveloped area.
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Objective The objective of this study was to observe the effect of AEG-1 gene on the metastasis in breast cancer MCF-7 cells.Methods AEG-1 siRNAs were transfected into MCF-7 cells to silence AEG-1 expression,and negative siRNA was used as a control.Transwell chamber was used to detect the ability of cell migration and invasion of MCF-7 cells.CCK8 assay was used to detect the cell proliferation of MCF-7 cells.At the same time,the effect of VEGF on the angiogenesis was investigated by detecting the changes of lumen formation in HUVEC cells.Results The migration,invasive and proliferative abilities were significantly inhibited in MCF-7 cells transfected with AEG-1 siRNA.Knockdown AEG-1 was significantly decreased the level of VEGF in the supernatant of MCF-7 cells.Knockdown AEG-1 was also significantly inhibited the angiogenesis activity in HUVEC cells.Conclusion Knockdown AEG-1 can significantly inhibit the migration of MCF-7 cells,including cell migration,invasion,proliferation and angiogenesis.These results suggest that AEG-1 plays an important role in the metastasis process of breast cancer and opens up new ideas for future treatment breast cancer.
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Objective To compare cognitive function and alexithymia between the schizophrenic patients treated with chlorpromazine and those treated with clozapine. Methods The patients with schizophrenia in stable condition that received maintenance treatment either with chlorpromazine or clozapine and normal control subjects were recruited (n=24 per group). Neuropsychological tests, including Digit Vigilance Test, Controlled Oral Word Association Test, Trail Making Test-A&B (TMT-A&B), Animal Naming Test, Stroop Color-Word Test, Block Design and Spatial Span Test were used to assess the participant’s cognitive function. The twenty-item Toronto Alexithymia Scale (TAS-20) were used to evaluate the participant’s alexithymia. Results The significant differences were found between the patients and the controls in all items of cognitive function and all factor scores of TAS-20 (P0.05). Multivari? ate linear regression analysis showed that in the clozapine group, attention function associated with the total score of TAS (β=-0.20, P<0.05), executive function associated with TAS factor 1 (β=-0.26, P=0.03), spatial function associated with TAS factor 2 (β=-0.24, P<0.01). In the chlorpromazine group, attention function associated with TAS factor 2 (β=-1.24, P<0.01), executive function associated with TAS factor 2 (β=-0.33, P=0.02). Conclusions Patients with schizophrenia in maintenance period have widely cognitive impairment and alexithymia, both of which are related to each other.
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Objective To observe the effect of core stability training on motor function, balance and activities for children with cerebral palsy. Methods 100 children with cerebral palsy were divided into control group (n=50) and treatment group (n=50). The control group ac-cepted routine physical therapy, occupational therapy, acupuncture, sensory integration training and conductive education;while the treat-ment group accepted core stability training in addition, 3 hours a day for 12 weeks. They were assessed with Gross Motor Function Measure (GMFM-88), Berg Balance Scale (BBS) and Comprehensive Functional Assessment for Disabled Children (CFA-DC) before and after treat-ment. Results The scores of GMFM-88, BBS and CFA-DC improved more in the treatment group than in the control group (P<0.05). Con-clusion Core stability training can further promote the recovery of motor, balance and activities in children with cerebral palsy.