Association of serum adiponectin with breast cancer: A meta-analysis of 27 case-control studies.

BACKGROUND: Emerging published studies have indicated that adiponectin is involved in tumorigenesis of breast cancer. However, the results of available studies were inconsistent. The aim of this updated meta-analysis was to assess the association of adiponectin with breast cancer. MATERIALS AND METHODS: PubMed, EMBASE, Wanfang databases, and the China National Knowledge Infrastructure (CNKI) were systematically searched from inception to June 2018. The mean difference (MD) with 95% confidence interval (CI) were estimated and pooled to investigate the effect sizes. RESULTS: Twenty-seven eligible articles that met the study criteria were included in the current meta-analysis. Overall, there was an evident inverse association between serum adiponectin levels and breast cancer (MD = -0.29, 95%CI = (-0.38, -0.21), P < .001). Asian subgroup showed a significant negative association between serum adiponectin concentrations and breast cancer in subgroup analysis by ethnicity (MD = -2.19, 95%CI = (-3.45, -0.94), P < .001). However, no statistical significance was found in Caucasian subgroup (MD = -0.65, 95%CI = (-1.47, 0.17), P = 0.12). Additionally, a further subgroup analysis of Asian stratified by menopausal status showed higher concentrations of adiponectin in healthy control group, whether they were premenopausal (MD = -0.85, 95%CI = (-1.50, -0.19), P = .01) or postmenopausal (MD = -2.17, 95%CI = (-4.17, -0.18), P = .03). No significant difference was observed concerning the association between serum adiponectin and breast cancer metastasis (MD = -1.56, 95%CI = (-4.90, 1.78), P = .36). CONCLUSION: The current meta-analysis suggests that the serum adiponectin may be inversely associated with breast cancer. Decreased serum adiponectin levels in premenopausal women may also be inversely associated with breast cancer risk other than postmenopausal status. In addition, low serum adiponectin levels in Asian women were more likely to be associated with breast cancer risk than Caucasian women.

Hydrogel from Acellular Porcine Adipose Tissue Accelerates Wound Healing by Inducing Intradermal Adipocyte Regeneration.

As an important component of the skin, intradermal adipocytes are closely associated with skin homeostasis and wound healing. Although studies have focused on the role of fibroblasts, keratinocytes, and inflammatory cells in wound healing, the role of adipocytes has not been fully investigated. Here, we verified whether the induction of adipocyte regeneration in a wound bed can effectively promote wound healing, finding that the hydrogel from acellular porcine adipose tissue in combination with adipose-derived stem cells can induce in situ adipogenesis in the wound microenvironment. The newly regenerated adipocytes enhanced fibroblast migration, accelerated wound closing, and enhanced wound epithelialization. More importantly, newly formed intact skin structure was observed after treating the wound with adipose-derived stem cell-loaded hydrogel from acellular porcine adipose tissue. These results show that hydrogel from acellular porcine adipose tissue might substantially improve re-epithelialization, angiogenesis, and skin-appendage regeneration, making it a promising therapeutic biomaterial for skin wound healing.

The Effects of Platelet-Rich Plasma and Adipose-Derived Stem Cells on Neovascularization and Fat Graft Survival.

BACKGROUND: Adipose-derived stem cell (ADSCs)-assisted and platelet-rich plasma (PRP)-assisted lipofilling aim to enhance angiogenesis and cell proliferation and are promising techniques for lipofilling. This study aimed to compare the outcomes of ADSCs-assisted and PRP-assisted lipofilling. METHODS: Adipose tissue and human venous blood were obtained from women with early breast cancer. Human ADSCs were isolated and amplified in vitro. PRP was extracted through double centrifugation. The effect of PRP on ADSCs proliferation was evaluated. In the in vivo study, 1 ml of adipose tissue with saline (control group), PRP (PRP group), or ADSCs (ADSCs group) was injected subcutaneously into the dorsum of nude mice. At 2, 4, 8, and 12 weeks after injection, tissues were assessed for volume retention and ultrasound abnormality. For histological assessment, hematoxylin and eosin staining were performed. RESULTS: Cytokines in PRP and blood were comparable. Regarding the in vitro assay, PRP significantly improved ADSCs proliferation, and the effect was dose-dependent. Concerning the in vivo study, for each time point, ADSCs-assisted lipofilling showed superior volume maintenance. Similarly, the PRP group showed improved angiogenesis and fat survival, as compared with the control group. The angiogenic effect of PRP was inferior to that of ADSCs at most time points. No significant difference was observed at 12 weeks after lipofilling. Complication rates were comparable between the PRP group and ADSCs group. CONCLUSIONS: PRP-assisted and ADSCs-assisted lipofilling can significantly improve the cosmetic results of grafted fat. PRP-assisted lipofilling, which is considered convenient and clinically available, is a promising technique to improve neovascularization and fat survival. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Prognostic implication of the primary tumor location in early-stage breast cancer: focus on lower inner zone.

BACKGROUND: The aim of this study was to investigate the prognostic significance of tumor location of lower inner zone (LIZ) on the survival of patients with early-stage breast cancer. METHODS: We retrospectively identified 961 breast cancer patients from Jan 2000 to Apr 2016 from hospital database. We evaluated overall survival (OS) and disease-free survival (DFS) in patients with tumors in and outside LIZ. Subgroup analyses were performed according to clinicopathological characteristics and treatment strategies. RESULTS: A total of 838 cases were finally included. Patients with tumor location of LIZ showed significantly lower survival rates than tumors in other sites in terms of DFS (p = 0.028) but not OS (p = 0.106). When stratified into subgroups, tumors in LIZ retained a significant worse prognosis in DFS in patients with HER-2-negative, high ki-67 expression breast cancers, those who received neoadjuvant chemotherapy, axillary nodal negative patients, and patients with lymphovascular invasion. Univariate and multivariate analyses suggested that tumor location of LIZ was an independent prognostic factor for DFS (p = 0.022). CONCLUSIONS: Our results suggested that tumor location of LIZ was an independent adverse prognostic factor for DFS in patients with early-stage breast cancer. Multicenter studies with larger sample size are needed to confirm the conclusion and anatomical experiments are desired to elaborate the mechanism.

A study on the relationship between chemotherapy-induced cognitive impairment and age in patients with breast cancer.

PURPOSE: To investigate the correlation of chemotherapy-induced cognitive impairment (CICI) with age in patients with triple-negative breast cancer (TNBC). METHODS: A total of 120 breast cancer patients with different ages and receiving chemotherapy were selected as breast cancer group, and another 120 healthy subjects were enrolled as healthy control group. Breast cancer group included 60 TNBC patients (TNBC group) and 60 patients without TNBC (non-TNBC group). Both breast cancer and healthy control group were further divided into young group (n=40), middle-aged group (n=40) and elderly group (n=40). For TNBC group and non-TNBC group, each age group had 20 patients. Then, mini-mental state examination (MMSE), retrospective memory (RM) and prospective memory (PM) questionnaires were performed separately. RESULTS: There were statistically significant differences in MMSE, RM and PM scale scores between breast cancer group and healthy control group (p<0.001). In breast cancer group, the MMSE score was negatively correlated with age (r=-0.614, p<0.001), and the RM scale and PM scale scores were positively related to age (r=0.527, 0.439, p<0.001). The differences in MMSE, RM and PM scale scores were statistically significant between TNBC group and non-TNBC group (p<0.05). Moreover, the scores of MMSE, RM scale and PM scale were statistically significant among the young, middle-aged and elderly group in both TNBC group and non-TNBC group (p<0.001). In young group, there were statistically significantly differences in scores of MMSE, RM scale and PM scale between TNBC group and non-TNBC group (p<0.001). In middle-aged and elderly group, the scores of MMSE, PM scale and RM scale also had statistically significant differences between TNBC group and non-TNBC group (p<0.001). Multivariate logistic regression analyses revealed that TNBC [odds ratio (OR)=3.659, p=0.004] and age (OR =1.128, p<0.001) were risk factors for the occurrence of cognitive impairment in patients with breast cancer. CONCLUSIONS: Patients receiving chemotherapy for breast cancer suffer from varying degrees of cognitive impairment. The cognitive impairment in TNBC patients is more severe than that in patients without TNBC, the difference being mainly detected in young patients. In addition, both TNBC and age are risk factors for CICI in breast cancer.

Clinicopathologic study of invasive micropapillary carcinoma of the breast.

Invasive micropapillary carcinoma (IMPC) is a rare subtype of breast carcinoma. It is presumed to be more aggressive than invasive ductal carcinoma (IDC), though it is uncertain whether the prognoses of IMPC and IDC differ. In this retrospective study, we compared the clinicopathologic characteristics and survival between 170 female patients with IMPC (pure or mixed with IDC) and 728 with pure IDC. The IMPC patients had higher clinical stages and histologic grades, higher incidences of lymphovascular invasion and axillary lymph node extracapsular extension, and a higher degree of lymph node involvement than IDC patients. Moreover, IMPC was associated with increases in estrogen receptor (ER) and progesterone receptor (PR) positivity and HER-2 overexpression. Although locoregional recurrence-free survival (LRRFS) and recurrence-free survival (RFS) were poorer in IMPC patients than IDC patients, overall survival and distant metastasis survival did not differ between the two groups. Multivariate analysis revealed that IMPC was an independent prognostic factor for LRRFS in breast cancer, and IMPC patients had poorer clinicopathologic characteristics and poorer RFS and LRRFS than IDC patients. We therefore suggest that to improve treatment decisions, patients with breast carcinoma be tested for the presence of this specific subtype.

Adductor canal block versus femoral nerve block for total knee arthroplasty: a meta-analysis of randomized controlled trials.

Femoral nerve blocks (FNB) can provide effective pain relief but result in quadriceps weakness with increased risk of falls following total knee arthroplasty (TKA). Adductor canal block (ACB) is a relatively new alternative providing pure sensory blockade with minimal effect on quadriceps strength. The meta-analysis was designed to evaluate whether ACB exhibited better outcomes with respect to quadriceps strength, pain control, ambulation ability, and complications. PubMed, Embase, Web of Science, Wan Fang, China National Knowledge Internet (CNKI) and the Cochrane Database were searched for RCTs comparing ACB with FNB after TKAs. Of 309 citations identified by our search strategy, 12 RCTs met the inclusion criteria. Compared to FNB, quadriceps maximum voluntary isometric contraction (MVIC) was significantly higher for ACB, which was consistent with the results regarding quadriceps strength assessed with manual muscle strength scale. Moreover, ACB had significantly higher risk of falling versus FNB. At any follow-up time, ACB was not inferior to FNB regarding pain control or opioid consumption, and showed better range of motion in comparison with FNB. ACB is superior to the FNB regarding sparing of quadriceps strength and faster knee function recovery. It provides pain relief and opioid consumption comparable to FNB and is associated with decreased risk of falls.

[Research progress of adipose-derived stem cells in skin wound healing].

Objective: To review the research progress of adipose-derived stem cells (ADSCs) in skin wound healing. Methods: The recent experiments and clinical studies on the role of ADSCs in skin wound healing were extensively retrieved and analyzed. Additionally, possible mechanisms and novel application strategies were proposed. Results: As confirmed by in vitro and in vivo experiments and clinical studies, ADSCs promote skin wound healing mainly by two mechanisms: differentiation to target cells that participate in skin wound healing and cytokines paracrine to promote proliferation and migration of various cell lines that are mandatory to promote skin wound healing. Moreover, scaffold materials and cell sheet technology may further add to the potency of ADSCs in promoting skin wound healing. Conclusion: Remarkable progress has been made in the application of ADSCs in skin wound healing. Further studies are needed to explore the application methods of ADSCs.

Gastrointestinal microbiome and breast cancer: correlations, mechanisms and potential clinical implications.

Gastrointestinal microbiome plays as a symbiont which provides protection effect against invading pathogens, aids in the immune system development, nutrient reclamation and absorption as well as molecule breakdown. And it may avert carcinogenesis through these biological activities. By now, studies have been carried out to elaborate the association between gastrointestinal microbiome and breast cancer. It has been implicated that breast cancer was substantially associated with estrogen-dependent and estrogen-independent functions of gastrointestinal microbiome. Evidence from animal experiments also confirmed mammary tumor-related changes in microbial community. The possible mechanisms involve estrogen metabolism, immune regulation, obese status and so forth. Based on the current evidence, cues on future management strategies of breast cancer such as antibiotics and dietary interventions are proposed. In conclusion, large-scale clinical studies and bench-based researches are needed to validate the associations and elaborate the mechanisms, so as to reduce the risk of breast cancer and improve the outcomes of those already diagnosed.

[EVALUATION OF AN OPTIMIZING PROTOCOL FOR FABRICATING A SCAFFOLD DERIVED FROM PORCINE SKELETAL MUSCLE EXTRACELLULAR MATRIX].

OBJECTIVE: To explore an optimized protocol of decellularization to fabricate an ideal scaffold derived from porcine skeletal muscle acellular matrix. METHODS: Serial-step protocol of homogenating-milling-detergent method was used to fabricate decellularized porcine muscle tissue (DPMT) derived from native porcine skeletal muscle tissue from adult pig waist. Histological method was used to assess the effects of decellularization and degreasing. Sirius red staining was used to analyze collagen components. Scanning electron microscopy, BCA assay, and PicoGreen assay were used to evaluate the ultrastructure, total protein content, and DNA content in DPMT. The adipose derived stem cells (ADSCs), NIH3T3 cells, and human umbilical vein endothelial cells (HUVECs) were cultured in extraction liquor of DPMT in different concentrations for 1, 3, and 5 days, then the relative growth rate was calculated with cell counting kit 8 to assess the toxicity in vitro. Live/dead cell staining was used to evaluate the cytocompatibility by seeding HUVECs on the surface of DPMT and co-cultured in vitro for 3 days. For in vivo test, DPMT was subcutaneously implanted at dorsal site of male specific-pathogen free Sprague Dawley rats and harvested after 3, 7, 14, and 28 days. Gross obersvation was done and transverse diameter of remained DPMT in vivo was determined. HE staining and immunohistochemical staining of CD31 were used to assess inflammatory response and new capillary rings formation. RESULTS: Decellularization of the porcine skeletal muscle tissue by homogenating-milling-detergent serial steps protocol was effective, time-saving, and simple, which could be finished within only 1 day. The decellularizarion and degreasing effect of DPMT was complete. The main component of DPMT was collagen type I and type IV. The DNA content in DPMT was (15.902±1.392) ng/mg dry weight, the total protein content was 68.94% of DPMT dry weight, which was significantly less than those of fresh skeletal muscle tissue[(140.727±10.422) ng/mg and 93.14%] (P<0.05). The microstructure of DPMT was homogeneous and porous. The result of cytocompatibility revealed that the cytotoxicity of DPMT was 0-1 grade, and HUVECs could stably grow on DPMT. In vivo study revealed DPMT could almost maintain its structural integrity at 14 days and it degraded completely at 28 days after implantation. The inflammatory response peaked at 3 days after implantation, and reduced obviously at 7 days. Difference was significant in the number of inflammatory cells between 2 time points (P<0.05). Neovascularization was observed at 7 days after implantation and the number of new vessels increased at 14 days, showing significant difference between at 7 and 14 days (P<0.05). CONCLUSIONS: The homogenating-milling-detergent serial-steps protocol is effective, time-saving, and reproducible. The DPMT reveals to be cell and lipid free, with highly preserved protein component. DPMT has good biocompatibility both in vitro and in vivo and may also have potential in promoting neovascularization.