Background and purpose: When patients have positive sentinel lymph node (SLN), axillary lymph node dissection (ALND) is usually performed, but most of them have no metastasis in the non-sentinel lymph node (nSLN). It is of great significance to predict metastasis of nSLN precisely. The aim of the study was to establish a nomogram for the intraoperative prediction of nSLN metastasis in breast cancer patients using one-step nucleic acid amplification (OSNA) techniques and to direct the subsequent therapy for breast cancer effectively. Methods: Of 552 breast cancer patients who underwent SLN biopsy in the 2010 OSNA clinical trial, 103 with SLN metastasis treated with ALND were assessed to establish a nomogram for intraoperative prediction of nSLN based on the molecular diagnosis. A validation cohort of 61 patients who met the similar criteria in the 2015 OSNA clinical trial subsequently validated it. Results: Primary tumor size, total tumor load, the number of positive SLNs and negative SLNs were associated with the presence of nSLN metastasis based on the multivariable logistic regression results, and a nomogram was established with these variables. Its area under the ROC curve was 0.814 for the predictive model and it was 0.842 in the re-validation cohort. The tumor size assessed by the postoperative histological examination was replaced by the size evaluated by the imaging examination, and the area under the ROC curve was 0.838. There was no statistically significant difference in the accuracy compared with the former validation data (P=0.7406). Conclusion: The predictive nomogram based on the molecular diagnosis can predict the nSLN metastases intra/post-operatively. It appears to be obviously superior to other predictive models and may help to guide the axillary management and to make decisions about radiation target region.

To detect cadmium ions, we constructed a specific microbial sensor and screened detecting cassettes and different fluorescence proteins. Blue fluorescence protein mTagBFP2 was selected as a reporter and a double-promoters model was used in the construction of the fusion reporter vector Pmer::merR-m-Pmer::mTagBFP2-pMD19-T. The reporter vector was then transformed into Escherichia coli MC4100 wild type strain. The medium, incubation time, initial density for induction, and the optimal detection range were determined. The specificity of the biosensor was also checked. The biosensor responded specifically to cadmium irons with low background, and the linear concentration range detection ranged from 0.1 to 75 μmol/L at the initial OD600 = 0.1 with 2 h incubation in IHMM medium. Thus we successfully constructed a specific biosensor to detect cadmium irons and provided useful strategies for development and optimization of microbial sensors to detect heavy metals.
Biosensing Techniques ; Cadmium ; analysis ; Escherichia coli ; Genetic Vectors ; Promoter Regions, Genetic

Objective To elucidate the effects of SP600125 at different concentrations on the proliferation and osteo-differentiation of human adipose-derived stem cells (hASCs).Methods The hASCs harvested were cocuhured with SP600125 at concentrations of 0 μmol/L,1 μmol/L,5 μmol/L and 10 μmol/L in growth medium (OM group) and in osteogenesis medium (OM group),respectively.The DNA quantitative assay was carried out to evaluate proliferation of the hASCs;flow cytometry was used to determine the effect of SP600125 on the cell cycles of hASCs;Alkaline phosphatase level (ALP) and calcium deposition tests were conducted to observe the effects of SP600125 at different concentrations on osteogenic differentiation of the hASCs.Results The proliferation of hASCs was inhibited by 42.1％ when the cells were cocultured with SP600125 at the concentration of 10 μmol/L;the suppression decreased with decreased concentration of SP600125.The hASCs of phase G0/G1 in GM cocultured with SP600125 at the concentration of 10 μmol/L were more than those in GM cocultured with dimethylsulfoxide at the same concentration.ALP test revealed that after 10 days of culture in vitro the staining was more and more weakened and scattered and the ALP activity was more and more decreased with the increased concentration of SP600125.The extracellular calcium deposition of hASCs after 14 days of culture in vitro showed that the size and number of calcium nodules decreased with the increased concentration of SP600125.Conclusion SP600125 can suppress the proliferation and osteogenic differentiation of hASCs in vitro.

Background and purpose:Sentinel lymph node biopsy has replaced axillary lymph node dissec-tion as the standard staging procedure in early breast cancer patients with clinically negative axillary lymph nodes. It is a critical step for staging and treatment. This study investigated the localization effect of a novel tracer for breast cancer sentinel lymph node biopsy [indocyanine green (ICG)-rituximab (R)], using the hind limb drainage in mice as an animal model.Methods:For exploring the optimal dose and imaging time, different doses of ICG-R were injected subcutane-ously to the dorsum of the foot in the BALB/c mice. Then the lfuorescence vasculature imaging instrument was used continuously to observe the popliteal fossa lymph node (as sentinel lymph node) from the injection to 3 h after injection. For exploring the sustained localization effect, the optimal dose of ICG-R was injected and the imaging instrument was used from imaging to 24 h after injection.Results:The time from injection to imaging and the time from injection to the optimal imaging were shortened with the increased doses, and the imaging rate of the second or third level node increased accordingly. The best dosage of the novel tracer was 0.12 μg (dosage of indocyanine green) and the time from injection to the optimal imaging was about 34 min. After the observation for 24 h, the imaging rate of sentinel lymphnode was maintained at 100%, and the imaging rate of the second and the third level lymph node increased from 0% to 20% and 10%, respectively.Conclusion:ICG-R could clearly locate the sentinel lymph node. There is no imaging of the second level lymph node within 6 h. The novel tracer has high value in the clinical application.

Objective:To observe the clinical efficacy of body acupuncture combined with FANG's scalp acupuncture in treating limb dysfunction in the remission stage of stroke and explore the mechanism. Methods:Sixty patients in the remission stage of stroke with limb dysfunction were divided into a control group and a treatment group using the random number table method,with 30 cases in each group.The control group was treated with ordinary acupuncture based on the conventional rehabilitation treatment,and the treatment group was additionally offered FANG's scalp acupuncture.The interventions were conducted once daily with 10 sessions as 1 course.The Fugl-Meyer assessment(FMA)and Barthel index(BI)scores and serum malondialdehyde(MDA)and superoxide dismutase(SOD)levels were compared after 2 treatment courses,and the clinical efficacy was evaluated. Results:After treatment,the FMA and BI scores increased in both groups(P<0.05)and were higher in the treatment group than in the control group(P<0.05).Both groups showed a decreased MDA level and an increased SOD level after the intervention,all showing statistical significance(P<0.05);there were significant differences between the two groups(P<0.05). Conclusion:Based on the conventional rehabilitation treatment,ordinary acupuncture used alone or in combination with FANG's scalp acupuncture can lower the oxidative stress level and improve limb function in treating limb dysfunction in the remission stage of stroke;body acupuncture plus FANG's scalp acupuncture can produce better results.

Objective To examine the efficacy, safety, economic benefits and social function of conventional antipsychotics combined with agomelatine in the treatment of schizophrenia patients with obsessive-compulsive symptoms. Methods Eighty schizophrenic patients with obsessive-compulsive symptoms were randomly divided into two groups. The study group was treated with conventional antipsychotic drugs combined with agomelatin, and the control group combined with clomipramine for 8 weeks. Positive and negative symptom scale (PANSS) and Yale-Brown obsessive-compulsion scale (Y-BCOS) were used to evaluate the symptoms at before treatment, at discharge and one month after discharge. Social disability screening scale (SDSS), treatment emergent symptom scale (TESS) and the economic benefits was used to evaluate the social function, treatment efficacy and economic status. Results Before treatment, there was no significant difference in the scores of each scale between the two groups (P＞0.05). There was no significant difference in PANSS scores between the two groups at all time points (P＞0.05). The difference between Y-BCOS score and pre-treatment value was higher in the study group than in the control group (P<0.05). The difference between SDSS score and pre-treatment value was higher in the study group than in the control group (P<0.05). The TMRs were lower in the study group than in the control group at one month after discharge (P<0.05). The TESS score was lower in the study group than in the control group at discharge and one month after discharge. The cost and income were higher and the cost-effect ratio was lower in the study group than in the control group at one month after discharge (P<0.05). PANSS and Y-BCOS were positively correlated with TMR, SDSS and CER (P<0.05), but not with TESS at one month after discharge (P＞0.05). TESS was positively correlated with TMR, SDSS and CER (P<0.05). Conclusion The treatment of conventional antipsychotics combined with agomelatine in schizophrenia patients with obsessive-compulsive symptoms are safe and effective. Patients can achieve better social function, good economic and social benefits.

OBJECTIVE: To investigate the clinical features and genetic variant of a child with X-linked dominant Alport syndrome (XLAS). METHODS: A child who had presented at the First Affiliated Hospital of Zhengzhou University in May 2019 was selected as the study subject. Clinical data of the child was collected. Next generation sequencing (NGS) was carried out for the child. Candidate variants were validated by Sanger sequencing of his family members. RESULTS: The child, a 12-year-old boy, had mainly manifested gross hematuria, proteinuria, nephrotic syndrome, and progressive renal impairment in conjunct with hearing loss. Kidney biopsy has revealed uneven glomerular basement membrane thickness. DNA sequencing revealed that the child and his mother have both carried a heterozygous c.2632G>A (p.G878R) variant of the COL4A5 gene, for which his father and brother were of the wild type. This variant was unreported previously. Based on the guidelines from the American College of Medical Genetics and Genomics, the variant was classified as pathogenic (PS1+PM1+PM2_Supporting+PP3). CONCLUSION The maternally derived hemizygous c.2632G>A (p.G878R) variant of the COL4A5 gene probably underlay the XLAS in this child. Above finding has enriched the mutational spectrum of the COL4A5 gene.
Male ; Female ; Humans ; Child ; Nephritis, Hereditary/genetics* ; Deafness ; Kidney Glomerulus ; Genomics ; Mothers

Purpose/Significance To analyze relevant patented technologies,and to provide experience for medical and commercial health insurance institutions to break through the data interaction blocking point and construct a multi-level medical security system.Method/Process The patentometrics method is used to analyze the data interaction patent technology between medical and health insurance institutions from four aspects:time trend,regional distribution,category distribution and text clustering.Result/Conclusion China should pay attention to the role of data interaction in deepening cooperation between medical and insurance institutions,improve the declaration,authorization,application and protection of high-quality patents,pay attention to cross-border integration and technology-driven,and innovate patent layout to meet technological development and social needs.

Circadian rhythm disorder is a common physiological change of cancer survivors, which is mainly manifested in rest activity rhythm change, sleep wake disorder and the decrease of sleep efficiency at night, which further affect their physiological, psychological outcome and disease outcome. This paper reviews the concept, mechanism, influence and intervention methods of circadian rhythm disorder in cancer patients, in order to provide references for effective intervention of circadian rhythm disorder in cancer survivors.

Objective:To develop and evaluate a nomogram prediction model for the 3-month mortality risk of patients with sepsis-associated acute kidney injury (S-AKI).Methods:Based on the American Medical Information Mart for Intensive Care-Ⅳ (MIMIC-Ⅳ), clinical data of S-AKI patients from 2008 to 2021 were collected.Initially, 58 relevant predictive factors were included, with all-cause mortality within 3 months as the outcome event. The data were divided into training and testing sets at a 7∶3 ratio. In the training set, univariate Logistic regression analysis was used for preliminary variable screening. Multicollinearity analysis, Lasso regression, and random forest algorithm were employed for variable selection, combined with the clinical application value of variables, to establish a multivariable Logistic regression model, visualized using a nomogram. In the testing set, the predictive value of the model was evaluated through internal validation. The receiver operator characteristic curve (ROC curve) was drawn, and the area under the curve (AUC) was calculated to evaluate the discrimination of nomogram model and Oxford acute severity of illness score (OASIS), sequential organ failure assessment (SOFA), and systemic inflammatory response syndrome score (SIRS). The calibration curve was used to evaluate the calibration, and decision curve analysis (DCA) was performed to assess the net benefit at different probability thresholds.Results:Based on the survival status at 3 months after diagnosis, patients were divided into 7?768 (68.54%) survivors and 3?566 (31.46%) death. In the training set, after multiple screenings, 7 variables were finally included in the nomogram model: Logistic organ dysfunction system (LODS), Charlson comorbidity index, urine output, international normalized ratio (INR), respiratory support mode, blood urea nitrogen, and age. Internal validation in the testing set showed that the AUC of nomogram model was 0.81 [95% confidence interval (95% CI) was 0.80-0.82], higher than the OASIS score's 0.70 (95% CI was 0.69-0.71) and significantly higher than the SOFA score's 0.57 (95% CI was 0.56-0.58) and SIRS score's 0.56 (95% CI was 0.55-0.57), indicating good discrimination. The calibration curve demonstrated that the nomogram model's calibration was better than the OASIS, SOFA, and SIRS scores. The DCA curve suggested that the nomogram model's clinical net benefit was better than the OASIS, SOFA, and SIRS scores at different probability thresholds. Conclusions:A nomogram prediction model for the 3-month mortality risk of S-AKI patients, based on clinical big data from MIMIC-Ⅳ and including seven variables, demonstrates good discriminative ability and calibration, providing an effective new tool for assessing the prognosis of S-AKI patients.