Comparing ChatGPT's and surgeon's responses to thyroid-related questions from patients.

BACKGROUND: For some common thyroid-related conditions with high prevalence and long follow-up times, ChatGPT can be used to respond to common thyroid-related questions. In this cross-sectional study, we assessed the ability of ChatGPT (version GPT-4.0) to provide accurate, comprehensive, compassionate, and satisfactory responses to common thyroid-related questions. STUDY DESIGN: First, we obtained 28 thyroid-related questions from the Huayitong app, which together with the two interfering questions eventually formed 30 questions. Then, these questions were responded to by ChatGPT (on July 19, 2023), junior specialist and senior specialist (on July 20, 2023) separately. Finally, 26 patients and 11 thyroid surgeons evaluated those responses on four dimensions: accuracy, comprehensiveness, compassion, and satisfaction. RESULTS: Among the 30 questions and responses, ChatGPT's speed of response was faster than that of the junior specialist (8.69 [7.53-9.48] vs. 4.33 [4.05-4.60], P <.001) and senior specialist (8.69 [7.53-9.48] vs. 4.22 [3.36-4.76], P <.001). The word count of the ChatGPT's responses was greater than that of both junior specialist (341.50 [301.00-384.25] vs. 74.50 [51.75-84.75], P <0.001) and senior specialist (341.50 [301.00-384.25] vs. 104.00 [63.75-177.75], P <0.001). ChatGPT received higher scores than junior specialist and senior specialist in terms of accuracy, comprehensiveness, compassion and satisfaction in responding to common thyroid-related questions. CONCLUSIONS: ChatGPT performed better than junior specialist and senior specialist in answering common thyroid-related questions, but further research is needed to validate the logical ability of the ChatGPT for complex thyroid questions.

Lacticaseibacillus casei ATCC334 Ameliorates Radiation-Induced Intestinal Injury in Rats by Targeting Microbes and Metabolites.

SCOPE: Gastrointestinal side effects are frequently observed in patients receiving medical radiation therapy. As Lacticaseibacillus casei ATCC334 potentially affects microbial ecosystem, the study hypothesizes that it may improve radiation-induced intestinal injury in rats by modulating the "gut microbiota-metabolite-barrier axis." METHODS AND RESULTS: Rats are fed one of three or no doses of L. casei ATCC334 for 7 days and then expose to a single dose of 9 Gy X-ray total abdominal irradiation. Supplementation with L. casei ATCC334 promote the proliferation of intestinal stem cells (ISCs), increase the expression of tight junction proteins, reduce intestinal permeability, and protect intestinal barrier integrity. Moreover, 16S rRNA sequencing show that medium and high doses of L. casei ATCC334 inhibit the growth of Escherichia/Shigella and favor Akkermansia proliferation. L. casei ATCC334 intervention reprogram the metabolic profile and inhibit putrescine production but promote alpha-linolenic acid (ALA) production. Notably, a decrease in putrescine and an increase in ALA are significantly correlated with the proliferation of ISCs and enhanced intestinal barrier function following L. casei ATCC334 intervention. CONCLUSION: These results highlight that medium and high doses of L. casei ATCC334 alleviate radiation-induced intestinal damage by enhancing the mucosal barrier and remodeling the gut microbiota structure and metabolic activity.

Methotrexate and low-dose corticosteroid: An effective alternate against corticosteroid-resistant granulomatous lobular mastitis.

AIM: Granulomatous lobular mastitis (GM) is an inflammatory breast disease with unknown etiology. Studies showed that some patients could achieve complete remission with corticosteroids and excisional surgery. However, some patients would suffer from corticosteroid resistance. We aim to report our single-center experience with the highest number of corticosteroid-resistant GM patients treated by methotrexate and low-dose corticosteroid. METHODS: The medical record database in our center was searched retrospectively for GM patients between January 2015 and January 2022. Patients suffered corticosteroid resistance and received methotrexate-containing regimen were included in this study. The clinical characteristics, management and outcomes were collected and analyzed. RESULTS: Eighty-one patients with the median follow-up of 18 months (range 5-61 months) were included. The median age was 30 years old (range 21-48 years). The common initial complaints were breast mass, pain, and erythema. The initial treatment of 80 (98.8%) patients was methylprednisolone. Patients were switched to methotrexate and low-dose corticosteroid due to corticosteroid resistance. Complete remission was achieved in 61 (75.3%) patients who received methotrexate and low-dose corticosteroid with or without segmental dissection. Nineteen methotrexate-resistant patients were referred for antimycobacterial treatment with the exception that one patient was lost during follow-up. Thirteen of them achieved complete remission, and the other five gained partial remission and received segmental dissection. None of these methotrexate-resistant patients recured. CONCLUSION: An approach with methotrexate and low-dose corticosteroid should be considered as an alternative method to corticosteroid-resistant GM patients.

Management of Granulomatous Lobular Mastitis and Risk Factors Associated with Recurrence.

BACKGROUND: Granulomatous lobular mastitis (GM), an inflammatory breast lesion with unknown etiology, is prone to recur. There is no global consensus on the optimal treatment at present. This study was conducted to show our step-by-step systemic procedure and discuss the recurrence risk factors of GM. METHODS: The medical record database was retrospectively searched for patients with GM treated in our hospital between January 2015 and September 2021. Patients were divided into non-recurrence group (group A) and recurrence group (group B). Demographic and clinical characteristics, treatment and follow-up were collected and analyzed. RESULTS: A total of 885 GM patients were included in our study, all of whom received step-by-step systemic management. The mean age was 33.2 ± 5.2 years. There were 760 (85.9%) patients in group A and 125 (14.1%) in group B. Univariate analysis showed that there was no statistically significant difference between the two groups in size of mass, pregnancy, hyperprolactinemia, bacterial cultures, erythema nodosum. Multivariate analysis showed that patients with purulent nipple discharge, skin lesion, bilateral disease and patients who need the combination of surgery and medication to achieve complete remission had higher risk of recurrence. CONCLUSIONS: We built a step-by-step systemic procedure for GM, and the recurrence rate was 14.1%. Prolactin level and microbiological results are important for the management of GM. Purulent nipple discharge, skin lesion, bilateral disease and patients who need the combination of surgery and medication to achieve complete remission are associated with GM recurrence. Prolonged maintenance therapy may secure a better prognosis.

Characteristics and Management of Granulomatous Lobular Mastitis Associated with Antipsychotics-Induced Hyperprolactinemia.

Background: Granulomatous lobular mastitis (GM) is a rare inflammatory breast disease. Reports focusing on GM caused by antipsychotic-induced hyperprolactinemia (HPRL) are very rare. Aim: To report a study of GM associated with antipsychotic-induced HPRL and discuss the mechanism and management. Materials and Methods: A retrospective review of patients with GM and psychiatric disorders were carried out. The clinical characteristics, management and outcome were collected and analyzed. The relationship between antipsychotics and GM was evaluated using the Naranjo Adverse Drug Reaction Probability Scale (Naranjo scale). Results: Nineteen female GM patients with psychiatric diseases, aged 21-39 years, who had received antipsychotics for 0.5-10.2 years were included. Most patients took multiple antipsychotics, and 10 (52.6%) took risperidone-containing regimens. Increased prolactin (PRL) was detected in all patients (range 35.15-200 ng/mL). The scores of Naranjo scale were 7-8, indicated the antipsychotics probably induced GM. All patients received systemic therapy, and were prescribed bromocriptine. Seven patients (36.8%) decreased the dose of antipsychotics, six (31.6%) switched antipsychotics, three (15.8%) continued the primary antipsychotics, and three (15.8%) discontinued antipsychotics. In addition, 14 patients (73.7%) received corticosteroid, 4 (21.1%) received antimycobacterials. PRL decreased to normal in 1 month. Seven patients (36.8%) received excisional surgery. After 12 months' follow-up (range 9-56 months), only three patients (15.8%) had a recurrence. Conclusion: Long-term use of antipsychotics may increase PRL levels, and lead to GM. It is vital to assess PRL level and reduce PRL to normal in patients with GM.

Management of life-threatening staphylococcal septic shock in a breastfeeding woman with breast abscess: A case report.

INTRODUCTION AND IMPORTANCE: Breast abscess is a common problem in breastfeeding women. However, septic shock secondary to methicillin resistant Staphylococcus aureus (MRSA) from breast abscess is very rare. Successful management of this condition in our center may provide experience of treatment for similar patients. CASE PRESENTATION: A 20-year-old breastfeeding woman with breast abscess was transferred to our center. General condition of the patient deteriorated rapidly to life-threatening septic shock. Culture of pus later demonstrated MRSA infection, with vancomycin susceptibility. Several measures were emergently implemented, including removal of necrotic tissue, continuous catheter irrigation and drainage, intravenous infusion of vancomycin, pumping norepinephrine, fluid resuscitation and transfusion of plasma. The patient was cured and discharged after 10 day's treatment. CLINICAL DISCUSSION: Life-threatening septic shock secondary to MRSA in breastfeeding women with breast abscess is very rare. Nevertheless, clinicians should remain vigilant to early symptoms and signs of septic shock. Catheter irrigation and drainage, vancomycin and fluid resuscitation are essential for septic shock in lactational breast abscess. CONCLUSIONS: We highlight the importance of the diagnosis and management of life-threatening septic shock secondary to MRSA in breast abscess to help us further understand this rare and fatal disease.

Invasive pleomorphic lobular carcinoma of the breast with multiple metastases: A case report.

INTRODUCTION AND IMPORTANCE: IPLC (Invasive Pleomorphic Lobular Carcinoma) accounts for less than 1% of breast cancer. To the best of our knowledge, this is one of the few reported cases in the IPLC with multiple metastases. The patient's general condition got improved after our treatment, which has a certain reference for the treatment of this kind of patient in the future. CASE PRESENTATION: A 42-year-old female with IPLC and multiple metastases. The IPLC malignant cells were positive for p120 (cytoplasmic) and human epidermal growth factor receptor 2, negative for estrogen receptor, progesterone receptor, and E-cadherin. There were nodular enhancement foci in the liver, which are considered the metastatic lesions of the breast, and the liver function was abnormal. Multiple metastatic lesions of the vertebral body, appendage of the whole spine, and sternum. And C7, T1, and T9 vertebrae showed compression fractures. CLINICAL DISCUSSION: IPLC has systemic metastasis which molecular typing by immunohistochemistry is HER-2 overexpression can choose chemotherapy combined with targeted therapy to prolong the survival time and improve the quality of life of patients. The patient was followed up. CONCLUSIONS: This paper reports a case of IPLC with multiple metastases and gives review literature. Our treatment of the patient can be a reference for other clinicians.

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.

Decellularization of porcine skeletal muscle extracellular matrix for the formulation of a matrix hydrogel: a preliminary study.

Extracellular matrix (ECM) hydrogels are used as scaffolds to facilitate the repair and reconstruction of tissues. This study aimed to optimize the decellularization process of porcine skeletal muscle ECM and to formulate a matrix hydrogel scaffold. Five multi-step methods (methods A-E) were used to generate acellular ECM from porcine skeletal muscle [rinsing in SDS, trypsin, ethylenediaminetetraacetic acid (EDTA), Triton X-100 and/or sodium deoxycholate at 4-37°C]. The resulting ECM was evaluated using haematoxylin and eosin, 4-6-diamidino-2-phenylindole (DAPI) staining, and DNA quantification. Acellular matrix was dissolved in pepsin and gelled at 37°C. Hydrogel response to temperature was observed in vivo and in vitro. ECM components were assessed by Masson, Sirius red, and alcian blue staining, and total protein content. Acellular porcine skeletal muscle exhibited a uniform translucent white appearance. No intact nuclear residue was detected by haematoxylin and eosin staining, while DAPI staining showed a few nuclei in the matrixes produced by methods B, C, and D. Method A generated a gel that was too thin for gelation. However, the matrix obtained by rinsing in 0.2% trypsin/0.1% EDTA, 0.5% Triton X-100, and 1% Triton X-100/0.2% sodium deoxycholate was nuclei-free and produced a viscous solution that formed a structurally stable white jelly-like hydrogel. The residual DNA content of this solution was 49.37 ± 0.72 ng/mg, significantly less than in fresh skeletal muscle, and decreased to 19.22 ± 0.85 ng/mg after gelation (P < 0.05). The acellular matrix was rich in collagen and glycosaminoglycan, with a total protein concentration of 64.8 ± 6.9%. An acellular ECM hydrogel from porcine skeletal muscle was efficiently produced.

[High risk factors of the third level of lymphatic metastasis in breast cancer patients received radical/modified mastectomy: an analysis of 746 cases].

OBJECTIVE: To study the high risk factors of the third level of lymphatic metastasis in breast cancer patients to guide clinical practice. METHODS: The clinical data of 746 breast cancer patients (all female, aged from 33 to 80 years with a median of 46 years) received radical or modified mastectomy between 2001 and 2011 was analyzed retrospectively. Eleven individual variables were selected to investigate high risk factors of the third level of lymphatic metastasis in different conditions. RESULTS: Axillary nodes metastasis status (OR = 4.541, 95%CI:3.569-5.776), tumor site (OR = 1.437, 95%CI:1.029-2.007), external nodes involved (OR = 3.809, 95%CI:1.683-8.618) and estrogen receptor (OR = 0.740, 95%CI:0.569-0.964) were high risk factors of the third level of lymphatic metastasis. Further analysis found that it is prone to happen a metastasis, especially when the tumor with a size over 5 cm and located at the lateral quadrant. Negative estrogen receptor was a risk factor of the third level lymphatic metastasis along with the tumor stage. CONCLUSION: For preoperative tumor biopsy shows Negative estrogen receptor of tumor stage T3 and over stage T3 when considering suspicious lymph node metastasis or external tissues metastasis intraoperatively should take in account into third level axillary lymph node dissection actively.

[Preparation and characterization of acellular adipose tissue matrix].

OBJECTIVE: To prepare human acellular adipose tissue matrix and to evaluate the cellular compatibility so as to explore a suitable bio-derived scaffold for adipose tissue engineering. METHODS: The adipose tissue was harvested from abdominal skin graft of breast cancer patients undergoing radical mastectomy or modified radical mastectomy, and then was treated with a series of decellularization processes including repeated freeze-thaw, enzyme digestion, and organic solvent extraction. The matrix was examined by histology, immunohistochemistry, DAPI fluorescence staining, and scanning electron microscopy to observe the the removal of cells and to analyze its composition of collagen type IV, laminin, and fibronectin, and microstructure. The 3rd passage human adipose-derived stem cells (hADSCs) were co-cultured with acellular adipose tissue matrix and different concentrations of extracted liquid (100%, 75%, 50%, and 25%). The cytotoxic effects of the matrix were tested by MTT. The biocompatibility of the matrix was detected by live/dead staining and scanning electron microscopy observation. RESULTS: The acellular adipose tissue matrix basically maintains intrinsical morphology. The matrix after acellular treatment consisted of extracellular matrix without any cell components, but there were abundant collagen type I; neither DNA nor lipid residual was detected. Moreover, the collagen was the main component of the matrix which was rich in laminin and fibronectin. At 1, 3, and 5 days after co-cultured with hADSCs, the cytotoxic effect of matrix was grade 0-1. The matrix displayed good cell compatibility and proliferation. CONCLUSION: The acellular adipose tissue matrix prepared by repeated freeze-thaw, enzyme digestion, and organic solvent extraction method remains abundant extracellular matrix and has good cellular compatibility, so it is expected to be an ideal bio-derived scaffold for adipose tissue engineering.

Efficacy and Safety Profile of Combining Sorafenib with Chemotherapy in Patients with HER2-Negative Advanced Breast Cancer: A Meta-analysis.

PURPOSE: The aim of the study was to evaluate the efficacy and safety of combining sorafenib with chemotherapy in patients with human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, American Society for Clinical Oncology abstracts, and European Society for Medical Oncology abstracts were searched. Randomized clinical trials that compared the efficacy and safety of sorafenib plus chemotherapy in patients with HER2-negative advanced breast cancer with placebo plus chemotherapy were eligible. The endpoints were progression-free survival (PFS), overall survival (OS), time to progression (TTP), duration of response (DOR), overall response rate (ORR), clinical benefits, and adverse effects. The meta-analysis was performed using Review Manager 5.2.6 (The Nordic Cochrane Centre), and the fixed-effect model weighted by the Mantel-Haenszel method was used. When considerable heterogeneity was found (p<0.1), further analysis (subgroup analysis, sensitivity analysis, or random-effect model) was performed to identify the potential cause. The results are expressed as hazard ratios or risk ratios, with their corresponding 95% confidence intervals. RESULTS: The final analysis included four trials comprising 844 patients. The results revealed longer PFS and TTP, and higher ORR and clinical benefit rates in patients receiving sorafenib combined with chemotherapy compared to those receiving chemotherapy and placebo. OS and DOR were similar in the two groups. Meanwhile, the incidence of some adverse effects, including hand-foot skin reaction/hand-foot syndrome, diarrhea, rash, and hypertension, were significantly higher in the sorafenib arm. CONCLUSION: Sorafenib combined with chemotherapy may prolong PFS and TTP. This treatment was associated with manageable toxicities, but frequent dose interruptions and reductions were required.

[Advancement of adipose-derived stem cells assisted autologous lipotransfer in breast repair and reconstruction].

OBJECTIVE: To review the latest progress in the major biological properties of adipose-derived stem cells (ADSCs) and ADSCs assisted autologous lipotransfer in breast repair and reconstruction. METHODS: Recent literature about ADSCs assisted autologous lipotransfer in breast repair and reconstruction was reviewed. RESULTS: ADSCs have multipotential differentiation capacity, and they could promote angiogenesis and regulate immune reactions. ADSCs assisted autologous lipotransfer can obtain satisfactory effectiveness in breast repair and reconstruction with few complications, but more studies are needed to confirm the long-term safety. CONCLUSION: ADSCs assisted autologous lipotransfer has good effectiveness in breast repaired and reconstruction. But further clinical trials are needed to confirm the long-term safety.

A clinical study on regional lymphatic chemotherapy using an activated carbon nanoparticle-epirubicin in patients with breast cancer.

The purpose of this study was to understand the short-term therapeutic effects of an activated carbon nanoparticle-epirubicin suspension for regional lymphatic chemotherapy in patients with breast cancer. One hundred and twenty patients with stage I, II, or III primary breast cancer were randomly divided into three groups: the lymphatic chemotherapy group using the activated carbon nanoparticle-epirubicin suspension, the epirubicin control group, and the activated carbon control group. Each group of 40 patients was further divided into two subgroups with the drug injected either 24 or 48 h before surgery. The terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) assay was used to determine cancer cell apoptotic indices in metastatic lymph nodes. The epirubicin concentration in the black-stained lymph nodes in the lymphatic chemotherapy treatment group was 4,144.64 ± 2,426.44 ng/g, which is significantly higher than in the epirubicin control group (335.87 ± 212.82 ng/g, P < 0.001). The plasma epirubicin concentrations at 0.5, 1.5, and 24 h postinjection in the regional lymphatic chemotherapy treatment group were significantly lower than in the epirubicin control group (P < 0.001). Tolerable mild pain was observed at the injection area after administration of the epirubicin-activated carbon nanoparticle suspension. No regional necrosis or adverse effects were found. The TUNEL assay demonstrated that there was no significant difference in the apoptotic indices in the metastatic lymph nodes from the three groups. Performing lymphatic chemotherapy by regionally injecting the epirubicin-activated carbon nanoparticle suspension could significantly enhance the drug concentration in the stained lymph nodes and lower the plasma drug concentration. The epirubicin-activated carbon nanoparticle suspension has the ability to release the drug slowly in the lymph nodes and, as a result, can prolong the chemotherapeutic effects.

[Preparation and biocompatibility of porcine skeletal muscle acellular matrix for adipose tissue engineering].

OBJECTIVE: Extracellular matrix is one of the focus researches of the adipose tissue engineering. To investigate the appropriate method to prepare the porcine skeletal muscle acellular matrix and to evaluate the biocompatibility of the matrix. METHODS: The fresh skeletal muscle tissues were harvested from healthy adult porcine and were sliced into 2-3 mm thick sheets, which were treated by hypotonic-detergent method to remove the cells from the tissue. The matrix was then examined by histology, immunohistochemistry, and scanning electron microscopy. The toxic effects of the matrix were tested by MTT. Human adipose-derived stem cells (hADSCs) were isolated from adipose tissue donated by patients with breast cancer, and identified by morphology, flow cytometry, and differentiation ability. Then, hADSCs of passage 3 were seeded into the skeletal muscle acellular matrix, and cultured in the medium. The cellular behavior was assessed by calcein-AM (CA) and propidium iodide (PI) staining at 1st, 3rd, 5th, and 7th days after culturing. RESULTS: Histology, immunohistochemistry, and scanning electron microscopy showed that the muscle fibers were removed completely with the basement membrane structure; a large number of collagenous matrix presented as regular network, porous-like structure. The cytotoxicity score of the matrix was grade 1, which meant that the matrix had good cytocompatibility. The CA and PI staining showed the seeded hADSCs had the potential of spread and proliferation on the matrix. CONCLUSION: Porcine skeletal muscle acellular matrix has good biocompatibility and a potential to be used as an ideal biomaterial scaffold for adipose tissue engineering.

[Clinical features and prognosis analysis of different breast cancer molecular subtypes].

OBJECTIVE: To investigate the clinical characteristics and prognosis of different breast cancer molecular subtypes. METHODS: Clinicopathological and follow-up data of 1153 cases of operable breast cancer were analyzed retrospectively. Their molecular subtypes were categorized as luminal A, luminal B, Her-2 over-expressing and basal-like subtypes, based on detection of ER, PR, Her-2 expression. The correlation of prognosis of different molecular subtypes with age, tumor size, lymph node status and clinical staging was analyzed. RESULTS: Among the 1153 cases, 791 cases (68.6%) were of luminal A subtype, 50 cases (4.3%) luminal B subtype, 53 cases (4.6%) Her-2(+)subtype, and 259 cases (22.5%) basal-like subtype. There were no statistically significant differences among different molecular subtypes regarding the age, tumor size, lymph node status, and clinical stage. 1006 cases had complete follow-up data and the analysis showed that distant metastasis of Her-2 over-expressing subtype was significantly higher than that in other subtypes (P = 0.005), but the differences of local recurrence rate in different molecular subtypes was not statistically significant (P > 0.05). Kaplan-Meier method was used to analyze the survival prognosis of different molecular subtypes, showing both DFS rate and OS rate of Her-2 over-expressing subtype were the lowest, with a statistically significant difference (Log rank test, P < 0.05). Univariate and multivariate analyses showed that molecular typing and lymph node status were independent prognostic factors affecting both DFS and OS. CONCLUSIONS: Her-2 over-expressing subtype has the worst prognosis. Molecular subtypes may provide important information to predict the prognosis of breast cancer and might be an important basis for individualized treatment of breast cancer in future.

Monitoring Insertion Force and Electrode Impedance during Implantation of Microwire Electrodes.

the electrical impedance and the insertion force were monitored during the implantation of the microwire electrodes. The data reveals distinct phases in the force and impedance profiles corresponding to the different mediums the electrodes pass through. The impedance is shown to be linearly related to the pressure exerted by the electrode on the dura (p < 0.05, R2>0.8). While both insertion force and the impedance could be used to determine when the electrode touches and breaks through the brain surface, the later, especially the phase angle of the impedance, is shown to be more consistent and sensitive. It is proposed that the electrode impedance be used to provide more objective and accurate estimation of 1) when the electrode touches the brain; 2) the load distribution among the wires of the microwire array, and 3) the mechanical and immunological interactions between the electrode and the tissue in-vivo. The method can potentially improve the accuracy of electrode placement, and enable the development of better surgical procedures and apparatus. The principle could also be applied to other situations, such as endoscopic and minimum invasive surgeries.

Flow-injection analysis and voltammetric detection of NADH with a poly-Toluidine Blue modified electrode.

Poly-Toluidine Blue film was prepared by electrooxidative polymerization at a glassy carbon electrode in a phosphate buffer solution. The resulting chemically modified electrode (CME) exhibited excellent electrocatalysis toward the oxidation of reduced nicotinamide coenzyme (NADH) with over a 450 mV decrease of the overpotential compared with that at a bare glassy carbon electrode. Two electrochemical determinations of NADH, cyclic voltammetry and flow injection analysis, were established based on the electrocatalytical performance of the resulting modified electrode. Under an identical determinate condition, the voltammetric detection for NADH gave a detection limit of 3.3 micromol L(-1) with a linear concentration range of 9.1 micromol L(-1) to 1.8 mmol L(-1). As a detector in a flow-injection system, the CME gave a detection limit of 0.1 micromol L(-1) for NADH with a linear concentration range of 1.0 micromol L(-1) to 3.2 mmol L(-1). Obviously, flow-injection analysis is superior to voltammetric detection in NADH determination for its lower detection limit and wider detectable linear range.

Simultaneous determination of dopamine and ascorbic acid at a poly(toluidine blue) modified electrode.

A novel polymer modified electrode is discussed in this paper. This resulting electrode can catalyze remarkably toward the electrochemical oxidations of dopamine (DA) and ascorbic acid (AA). Moreover, it can clearly discriminate the electrochemical oxidations of DA from that of AA based on their semi-derivative voltammograms. Hence, a simultaneous determination of DA and AA based on semi-derivative voltammetry at a poly(toluidine blue) modified electrode is suggested. The detection linear range for DA is 0.4 micromol L(-1)-1.5 mmol L(-1), and AA 0.2 micromol L(-1)-2.4 mmol L(-1), respectively. The resulting modified electrode was tentatively used to determine DA and AA in brain tissue.