Locally advanced breast cancer patients should be cautious about the immediate breast reconstruction after mastectomy: a pooling analysis of safety and efficacy.

BACKGROUND: The purpose of this study was to compare safety and efficacy outcomes between immediate breast reconstruction (IBR) and mastectomy alone in locally advanced breast cancer patients. METHODS: We conducted a comprehensive literature search of PUBMED, EMBASE, and Cochrane databases. The primary outcomes evaluated were overall survival, disease-free survival, and local recurrence. The secondary outcome was the incidence of surgical complications. All data were analyzed using Review Manager 5.3. RESULTS: Sixteen studies, involving 15,364 participants were included in this meta-analysis. Pooled data demonstrated that patients underwent IBR were more likely to experience surgical complications than those underwent mastectomy alone (HR: 3.96, 95%CI [1.07,14.67], p = 0.04). No significant difference was found in overall survival (HR: 0.94, 95%CI [0.73,1.20], p = 0.62), disease-free survival (HR: 1.03, 95%CI [0.83,1.27], p = 0.81), or breast cancer specific survival (HR: 0.93, 95%CI [0.71,1.21], p = 0.57) between IBR group and Non-IBR group. CONCLUSIONS: Our study demonstrates that IBR after mastectomy does not affect the overall survival and disease-free survival of locally advanced breast cancer patients. However, IBR brings with it a nonnegligible higher risk of complications and needs to be fully evaluated and carefully decided.

Impact of preoperative type 2 diabetes mellitus on the outcomes of patients with gastric cancer following gastrectomy: Analysis of 834 patients using propensity score matching.

The purpose of the current study was to compare the outcomes of patients with gastric cancer (GC) between the type 2 diabetes mellitus (T2DM) group and the non-T2DM group. The PubMed, Embase and Cochrane Library databases were searched from inception to March 8, 2022, to identify propensity score matching (PSM) studies that analyzed the effect of T2DM on the outcomes of patients with GC. Total complications, overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS) were compared between the T2DM group and the non-T2DM group. A total of four PSM studies with 834 patients were included in the current study. There were 311 and 523 patients in the T2DM group and the non-T2DM group, respectively. Baseline characteristics of the two groups were adjusted with PSM in all the four studies, however, no significant difference was found in baseline characteristics (P>0.05). DFS was significantly worse in the T2DM group compared with that in the non-T2DM group [hazard ratio (HR), 1.45; 95% confidence interval (CI), 1.10-1.90; P=0.007)]. However, after pooling up the data, there was no significant difference between the T2DM group and the non-T2DM group in terms of OS (HR, 1.41; 95% CI, 0.92-2.16; P=0.11), CSS (HR, 1.29; 95% CI, 0.92-1.81; P=0.14) and total complications (odds ratio, 1.01; 95% CI, 0.64-1.60; P=0.95). Patients with GC and T2DM are associated with poor DFS. However, there were no significant differences between the T2DM group and the non-T2DM group in terms of OS, CSS and total complications.

The Effect of Surgical Approach on Clinical Outcomes in 535 Patients with Remnant Gastric Cancer.

Purpose: This study aimed to evaluate the effect of laparoscopic gastrectomy (LG) and open gastrectomy (OG) on clinical outcomes in patients with remnant gastric cancer (RGC). Materials and Methods: The databases of PubMed, EMBASE, and Cochrane Library were used to search for eligible studies from inception to April 1st, 2023. Hazard ratios (HRs), mean difference (MD), odds ratios (OR), and 95% confidence intervals (CIs) were pooled up to analyze. The Newcastle-Ottawa Scale (NOS) scores were used to evaluate the quality of the included studies. This study was performed with RevMan 5.3 (The Cochrane Collaboration, London, United Kingdom) software. Results: A total of 11 studies involving 535 RGC patients were included in this study. In terms of basic information, we found that the OG group had a higher American Society of Anesthesiologists (ASA) grade (≥2) (OR = 0.24, I2 = 54%, 95% CI = 0.08-0.71, P = .01) than the LG group. In terms of postoperative outcomes, we found that the LG group had longer operative time (MD = 33.95, I2 = 58%, 95% CI = 15.05-52.85, P < .01), shorter postoperative hospital stay (MD = 5.08, I2 = 84%, 95% CI = -9.74 to -0.42, P = .03), shorter length of incision (MD = -7.15, I2 = 94%, 95% CI = -10.99 to -3.31, P < .01), earlier food intake (MD = -3.09, I2 = 76%, 95% CI = -4.84 to -1.35, P < .01), and earlier time to first flatus (MD = -0.84, I2 = 0%, 95% CI = -1.09 to -0.59, P < .01). We found that there was no statistically significant difference in overall survival (HR = 0.96, I2 = 0%, 95% CI = 0.48-1.93, P = .92) between the LG group and the OG group. Conclusion: LG for RGC patients had longer surgical time, shorter postoperative hospital stay, shorter length of incision, earlier food intake, and earlier time to first flatus.

Are High Levels of Microsatellite Instability and Microsatellite Stability Identical in DNA Mismatch Repair-Deficient Colorectal Cancer Patients?

Purpose: The purpose of the current study was to determine whether there is a difference between high levels of microsatellite instability (MSI-H) and microsatellite stability (MSS) in DNA mismatch repair-deficient (DMMR) colorectal cancer (CRC) patients. Methods: A total of 452 CRC patients with DMMR from December, 2014, to April, 2021, in our hospital were selected retrospectively. However, only 105 patients underwent Sanger or next-generation-sequencing (NGS) to confirm their microsatellite status. Ultimately, 55 MSI-H patients and 20 MSS patients with intact medical record information were included in this study. Results: The MSS group was associated with a higher mutation rate in the KRAS gene (P=0.011). Meanwhile, MSI-H was related to colon cancer (P < 0.01). However, no significant differences in other clinical characteristics were observed between the two groups of patients. There was no significant difference between the MSI-H and MSS groups in terms of overall survival (OS) (P=0.398) and disease-free survival (DFS) (P=0.307). Conclusion: The MSI-H status was associated with colon cancer and a lower mutation rate of the KRAS gene in DMMR patients. In CRC-DMMR patients, the MSS group exhibited better OS and DFS than the MSI-H group, although these differences were not statistically significant. Accordingly, in clinical practice, we should not confuse these two types of patients.

Mechanochemically synthesized zeolitic imidazolate framework-8 as sorbent for dispersive solid-phase extraction of benzophenone-type ultraviolet filters in aqueous samples.

Benzophenone-type ultraviolet filters (BP-UVFs) are a group of emerging contaminants, which found in various environmental aqueous samples raising potential risks for public health concern and could bioaccumulate in the food chain. This study describes a simple and "green" method to rapidly analyze five BP-UVFs that are frequently found in surface water and in seawater samples. Dispersive solid-phase extraction (DSPE) using a zeolitic imidazolate framework­8 (ZIF-8) as the sorbent was applied to efficiently extract the BP-UVFs from aqueous samples, and they were then detected and quantified by UHPLC-electrospray ionization (+)-quadrupole time-of-flight mass spectrometry (UHPLC-ESI (+)-QTOF-MS). The ZIF-8 sorbent was synthesized by a green one-step mechanochemical process using water-assisted grinding and a stoichiometric reaction. The Box-Behnken Design coupled with the response surface method was applied to optimize the main DSPE extraction factors. The developed method was fully validated, showing low limits of quantification (LOQs; 0.3-20 ng L-1), satisfactory mean spiked recoveries (72-105%), and a high level of precision (3-9%). A preliminary analysis of the surface water and seawater samples revealed that 2-hydroxy-4-methoxybenzophenone (BP-3) was the most common BP-UVF present in our aquatic environment, likely due to its widespread applications and slow rate of degradation.

Genetic Characteristics of Resectable Colorectal Cancer with Pulmonary Metastasis.

The lung is the most common extra-abdominal metastasis site of colorectal cancer (CRC). This study aimed to investigate the genetic variation of pulmonary metastases (PM) and primary tumors in resectable CRC. The clinical data of 410 patients with PM after CRC surgery and 33 paraffin-embedded tissue samples from January 2012 to July 2019 in our hospital were collected retrospectively. Next, 450-panel gene detection technologies based on next-generation sequencing (NGS) were used to analyze the changes in the gene map and the overall variation in cancer-related genes in PM and primary tumors. After quality control, 19 samples were included in the final gene analysis. The results showed that APC (89.5%), TP53 (89.5%), and KRAS (53%) were the most common mutations in PM and primary tumors, but the gene amplification variation was enriched in primary tumors (4.6% vs. 11.4%). KRAS G12D was the most common site variation of the KRAS gene in both PM and primary tumors of CRC. There was no hotspot mutation in the TP53 locus in CRC, and the TP53 mutation in the PM was consistent with that in the primary lesion. The microsatellite instability (MSI) levels of 10 patients were MSS. The mean tumor mutation burden (TMB) of the primary tumor (5.3 muts·Mb-1) was slightly higher than that of metastasis (5.0 muts·Mb-1). In our institution, the genetic characteristics of resectable PM from CRC may be highly consistent with those of the primary tumor.

Endoscopic incision of rectal diverticulum: A case report.

A 70-year-old woman with a rectal diverticulum presented with anal pendant expansion and difficulty in defecation for more than 1 year. The patient was diagnosed with a rectal diverticulum by pelvic enhanced magnetic resonance imaging (MRI), computerized tomography (CT), rectal angiography, and colonoscopy. The endoscopic diverticulum incision procedure (EDIP) was implemented with this patient. At the 4-month follow-up, anal pendant expansion and difficulty in defecation were significantly relieved. Furthermore, colonoscopy proved that there were no vestigial feces in the diverticulum.

Epidemiological analysis of malaria surveillance in Jinan City from 2012 to 2016 / 中国血吸虫病防治杂志

Objective To analyze the epidemiological characteristics of malaria reported in the malaria surveillance system in Jinan City from 2012 to 2016,so as to provide the evidence for improving the ability of diagnosis,treatment,prevention and control of malaria.Methods The data of all reported malaria cases in the malaria surveillance system were retrospectively ana-lyzed.Results From 2012 to 2016,91 malaria cases were found in Jinan City,of which one patient died.All the cases were imported and 95.60%(87 cases)of them came from Africa(note:most of the people were Chinese residents who had been in Af-rica for the export of labor service and came back China).Falciparum malaria accounted for the most(82.42%,75 cases).All the cases were adult males,and were mainly migrant workers.The median time from onset to being confirmedly diagnosed was 5 days,and the median time from seeing a doctor to being diagnosed was 1 day.The medical institutions where the patients first visited were mainly municipal medical institutions(42 cases,46.15%).The misdiagnosis rate was 100% in village clinics and township health centers(8/8 and 2/2,respectively). The misdiagnosis rate was lowest in the municipal medical institutions (3/42,7.14%).There were 41 malaria patients(45.05%)with complications.Conclusions The situation of overseas imported malaria in Jinan City is becoming more and more serious.It is necessary to further strengthen the related professional training for doctors and strengthen the multi-sectoral cooperation for health education,etc.in order to find the cases in time and conduct the active standardized treatment,so as to prevent the second generation cases.

[Epidemiological analysis of malaria surveillance in Jinan City from 2012 to 2016].

OBJECTIVE: To analyze the epidemiological characteristics of malaria reported in the malaria surveillance system in Jinan City from 2012 to 2016, so as to provide the evidence for improving the ability of diagnosis, treatment, prevention and control of malaria. METHODS: The data of all reported malaria cases in the malaria surveillance system were retrospectively analyzed. RESULTS: From 2012 to 2016, 91 malaria cases were found in Jinan City, of which one patient died. All the cases were imported and 95.60% (87 cases) of them came from Africa (note：most of the people were Chinese residents who had been in Africa for the export of labor service and came back China). Falciparum malaria accounted for the most (82.42%, 75 cases). All the cases were adult males, and were mainly migrant workers. The median time from onset to being confirmedly diagnosed was 5 days, and the median time from seeing a doctor to being diagnosed was 1 day. The medical institutions where the patients first visited were mainly municipal medical institutions (42 cases, 46.15%). The misdiagnosis rate was 100% in village clinics and township health centers (8/8 and 2/2, respectively). The misdiagnosis rate was lowest in the municipal medical institutions (3/42, 7.14%). There were 41 malaria patients (45.05%) with complications. CONCLUSIONS: The situation of overseas imported malaria in Jinan City is becoming more and more serious. It is necessary to further strengthen the related professional training for doctors and strengthen the multi-sectoral cooperation for health education, etc. in order to find the cases in time and conduct the active standardized treatment, so as to prevent the second generation cases.

Analysis on incidence of bacillary dysentery in Jinan municipality from 1951 to 2005 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the epidemic characteristics of bacterial dysentery in Jinan municipality, and to provide scientific basis for effective strategy for bacterial dysentery control.</p><p><b>METHODS</b>The epidemiological characteristics of bacillary dysentery in Jinan from 1951 to 2005 were analyzed. A total of 485,333 cases in the span of 50 years were recorded, while the population-based case distribution was less than the total cases due to the data incompleteness during the Cultural Revolution.</p><p><b>RESULTS</b>The incidence of bacillary dysentery in Jinan has been decreasing by years with average incidence rate of 283.10/100,000. The significant differences were observed among the incidence rates of various ages(chi2 = 14.99, P < 0.05). There were four epidemic peaks, and all the incidence rates were about 1000/100,000. Age of onset mainly concentrated in the 0-4 years old, 20-years old and 30-years old. In terms of occupational distribution, workers accounted for 30.31%, the living-scattered children accounted for 22.71%, and the farmers accounted for 17.90%. The incidence focus was from July to September, which accounted for 71.57%. The peak of incidence emerged in August. The highest incidence in urban was 550.94/100,000.</p><p><b>CONCLUSION</b>Through the efforts of several generations of health workers, the incidence of bacillary dysentery in Jinan has been basically brought under control. Further step should be taken for the control of bacterial dysentery in urban areas and the management of bacterial dysentery in rural areas. Moreover, the biological characteristics of F2a should be a focus for the future study.</p>