Objective To evaluate the value of fine needle aspiration (FNA) and core needle biopsy (CNB) in highly suspicious breast malignant lesions in terms of diagnostic accuracy,complication rate and cost-effectiveness.Methods We retrospectively reviewed records of patients with imaging diagnosis of BI-RADS 4c or 5 categories who have undergone either FNA or CNB under ultrasound guidance in Peking University People's Hospital from 2012 to 2014.Sensitivity,specificity,diagnostic accuracy,positive predictive,negative predictive,false positive rate,false negative rate,accuracy rate and unsatisfactory rate (non-diagnostic rate) were calculated and compared between FNAC and CNB.The complication of the procedures,operation time and cost were assessed.Results Among 638 consecutive cases,273 of them underwent FNA,and 365 underwent CNB.The accuracy rate of FNA and CNB were 99％ and 97.2％.The sensitivity,specificity,diagnostic accuracy,positive predictive,false positive rate and false negative rate were similar between the two groups.The unsatisfactory rate of FNA was significantly higher than that of CNB (25.3％ vs.10.9％,x2 =22.59,P =0.000).There was not severe complication in either groups,while subcutaneous ecchymosis and hematoma were more common in FNA group than in CNB group.The operation time of FNA was shorter than that of CNB (4.8 ± 1.3 min vs.15.5-± 1.7 min,P =0.000).The waiting time for final pathological report was shorter in patients undergoing FNA (1 vs.3 days).An estimated cost for FNA was RMB 447.5 Yuan/case,whereas that was 995 Yuan/case for CNB.Conclusions FNA and CNB are both accurate and safe preoperative diagnostic procedures.FNA is a simple and cost-effective method.

Background and purpose:Neoadjuvant chemotherapy is an excellent model for evaluation of predictive parameters.The goal of predictive parameters is to select patients who would most likely benefit from neoadjuvant chemotherapy.The objective of this study was to investigate the predictive value of biological markers for the patients' response to neoadjuvant anthracycline combined with taxanes chemotherapy.Methods:We investigated 160 patients with breast cancer who underwent 4 cycles of neoadjuvant anthracycline combined with taxanes chemotherapy,retrospectively.The expression of estrogen receptors(ER),progesterone receptors(PgR),Her2,Topo-Ⅱ and Ki-67 proteins were detected by immunohistochemical assay in core-needle biopsy specimens.The associations between biological markers as well as clinical and pathologic responses were analyzed.Results:The overall clinical response was 85%,including 28.8%(46/160) with clinical complete response(cCR) and 56.3%(90/160) with clinical partial response.The pathological complete response(pCR) was 14.4%.In the univariate analysis,absence of ER,PgR expression and over-expression of Her-2 were predictive of the cCR and pCR(P

Objective: To analyze the relationship between hemoglobin ( Hb ) and serum uric acid ( SUA ), so as to provide basis for preventing hyperuricemia ( HUA ) . Methods: As the research subjects, people who underwent physical examination in Zhejiang Provincial People's Hospital from January 1, 2017 to October 31, 2020 for 4 years in a row and who were non-HUA in 2017 were selected. The physical examination data were collected, including body mass index, blood pressure, blood routine, blood biochemical tests, etc. The subjects grouped by quartiles of Hb level in 2017. The occurrence of SUA elevation ( SUA increased ≥60 μmol/L from baseline ) , significantly SUA elevation ( SUA increased ≥120 μmol/L from baseline ), HUA ( SUA>420 μmol/L ) and severe HUA ( SUA ≥480 μmol/L ) in the next 3 years were taken as end events. The incidence, occurrence time and risk of end events in different Hb groups were analyzed. Results: A total of 4 073 subjects were selected and divided into 4 groups according to the Hb level from low to high, with 969 subjects in group A, 907 subjects in group B, 1 109 subjects in group C and 1 088 subjects in group D. SUA elevation was in 745 patients ( 18.29% ); significantly SUA elevation was in 105 patients ( 2.58% ); HUA was in 514 patients ( 12.62% ); severe HUA was in 94 patients ( 2.31% ). The incidence of SUA elevation and significantly SUA elevation showed a decreasing trend with the increase of Hb level ( P<0.05 ). The occurrence time of SUA elevation in group A to D was 2.788, 2.817, 2.860 and 2.814 years, and the difference was statistically significant ( P<0.05 ). There were no statistically significant differences in the occurrence time of other end events ( P>0.05 ). The multivariate Cox proportional hazards regression analysis showed that compared with group A, other Hb groups had lower risk ( HR=0.498-0.776, 95%CI:0.253-0.981 ) of SUA elevation, significantly SUA elevation and severe HUA after adjusting for gender, age, ALT, Scr, body mass index, etc. Conclusions With the increase of Hb level, the incidence of SUA elevation may decrease and the occurrence time is prolonged. Compared with the lowest Hb group, the higher Hb groups had lower risk of SUA elevation, significantly SUA elevation and severe HUA.

Objective To investigate the iodine nutritional status of targeted population in the high-risk areas of iodine deficiency disorders in Chongqing, so as to provide scientific evidence for establishing prevention and remedial measures. Methods Six towns were selected in Chengkou and Wuxi Counties to found suspected dementia patients born after first Jan, 1997. Two hundred children aged 8-10 years were investigated in every town. The thyroid volume, intelligence quotient(IQ) and urinary iodine of the children were examined. Forty women (pregnant and nursing women) were investigated in every town. The iodine content of salt from their home was measured. The thyroid volume was examined by palpation and B-uhrasound. IQ was measured by combined Raven Test in China(CRT-RC2). Urinary iodine was determined using the acid digest arsenic-cerium contacting method, and iodined salt was detected using direct titration method. Results Six suspected dementia patients were found in the local town hospital. Five eases were excluded. There was 1 case born in other place. The rates of goiter by palpation and B-ultrasound were 9.58%(92/960) and 8.89%(65/731), respectively. The median of urinary iodine of children and women was 319.15 μg/L and 248.42 μg/L, respectively. The mean of IQ of the children was 103.32. The coverage rate of iodine salt from residents was 98.82%(336/340). Conclusions The iodine nutrition of children was good and there is no newly occurred cretinism in Chengkou and Wuxi Counties. Goiter rate and median of urinary iodine aged 8-10 years and of women, coverage rate of iodine salt from resident has meet the standard set for basical elimination iodine deficiency disorders.

Objective To investigate the feasibility of ~1H-MR spectroscopy(~1H-MRS)imaging to quantitatively detect fatty liver.Methods Twenty patients with fatty liver and 11 healthy volunteers underwent plain CT scan,conventional MR imaging and ~1H-MRS analysis.The blood lipid and liver function were tested on the same day as the MR examination.~1H-MRS sequence measured the peaks of H_2O and lipid,and the areas under the peaks.The relative contents of the lipid compound were calculated,and compared with the results of CT scan and liver function tests.Results The CT values of the normal group and the fatty liver group were(59?9)HU and(24?11)HU respectively.On ~1H-MRS a protruding high H_2O peak and a flat low lipid peak were observed in the normal group,while the protruding high H_2O peak and a high lipid peak appeared in the fatty liver group.The values of lipid peak in the normal group and the fatty liver group were(0.05?0.01)?10~5,(0.70?0.24)?10~5 respectively(t=4.32,P0.05),the areas under the lipid peak were(1.36?0.73)?10~9、(2.35?1.15)?10~9 respectively(t=5.21,P0.05).Conclusion ~1 H-MRS imaging is feasible to quantitatively detect liver fat and is a non-invasive method for detecting early fatty liver.

Asian Continental Ancestry Group ; BRCA1 Protein/genetics* ; Breast Neoplasms/surgery* ; China ; Female ; Genetic Testing ; Humans ; Mastectomy

OBJECTIVE CYP2D is one of the most abundant subfamily of CYPs in the brain, especially in the cerebellum. Brain CYP2D is responsible for the metabolism of endogenous neurotransmitters such as tyramine and serotonin. Our previous studies have shown brain CYP2D can be regulated by exogenous and endogenous substances with tissue- specificity. The purpose of this study is to examine the effects of cerebral CYP2D on the mice behavior and the regulatory mechanism of brain CYP2D by growth hormone. METHODS Mice received the stereotaxic injection with CYP2D inhibitor quinine in deep cerebellar nuclei of cerebellum. The animals were tested with rotarod apparatus, balance beam, water maze, elevated plus maze and open field. The changes in CYP2D22, PPARαand PPARγ in brain regions and liver were assayed in male growth hormone receptor knockout mice, SH-SY5Y cells and HepG2 cells. RESULTS The inhibition of cerebellum CYP2D significantly affected the spatial learning and exploring ability of mice. Compared with WT mice, CYP2D expression was lower in brain regions from GHR(-/- ) male mice; however, hepatic CYP2D level was similar. Pulsatile GH decreased PPARα mRNA level, and increased mRNA levels of CYP2D6 and PPARα in SH- SY5Y cells. In HepG2 cells, pulsatile GH resulted in decreases in PPARα and PPARγ mRNA levels, but not CYP2D6. PPARα inhibitor induced CYP2D6 mRNA and protein by 1.32-fold and 1.43-fold in SH-SY5Y cells. PPARγ inhibitor decreased CYP2D6 mRNA and protein by 74.76% and 40.93%. PPARα agonist decreased the level of CYP2D22 mRNA in liver and cerebellum, while PPARγ agonist rosiglitazone resulted in diametrically increases. The luciferase assay showed that PPARγ actived the CYP2D6 gene promoter while PPARα inhibited its function. Pulsatile GH declined the binding of PPARα with CYP2D6 promoter by 40%, promoted the binding of PPARγ with CYP2D6 promoter by approximate 60%. The levels of brain and liver PPARα expression in male GHR(-/- ) mice is obviously higher than those in WT mice. The level of PPARγ in male GHR(-/- ) mice was decreased in the frontal cortex and hippocampus, while remained stable in the cerebellum and striatum; meanwhile, PPARγ was increased in the liver. CONCLUSION Brain CYP2D may be involved in learning and memory functions of central system. Masculine GH secretion altered the PPARs expression and the binding of PPARs to CYP2D promoter, leading to the elevated brain CYP2D in a tissue- specific manner. Growth hormone may specifically alter the metabolic and synthetic of important endogenous substances in the central nervous system (such as serotonin) through the specific regulation of brain CYP2D expression.

Objective To observe the combined poisonous effects of fluoride and aluminum on sex hormone of male rats.Methods Sixteen weaned SD healthy male rats aged two week were selected and divided into control group,aluminum group,fluoride group,fluorine-aluminum group,four rats in each group.All rats in the experimental groups were fed with corn collected from the prevailng areas containing different fluorine contents respectively for 90 days.Serum testosterone(T)and estradiol(E2)were detected.Results Compared separatelv with the control group[(3.317±0.635)μg/L],serum T level of fluorine-aluminum group[(15.994±6.558)μg/L]was higher(P＜0.05),but aluminum[(8.134±3.134)μg/L]and fluorine[(1.868±0.367)μg/L]groups had no significant differences(P＞0.05).Compared separately with the control group[(0.319±0.072)nmol/L],E2 level of the fluorine group[(0.172±0.030)nmol/L]being lower(P＜0.05),and it was not significant differences(P＞0.05)in the control group when compared with aluminum group[(0.282±0.012)nmol/L],and fluorine-aluminum group[(0.265±0.047)nmol/L].Fluorine and aluminum interacted with each other(F=9.82,P＜0.05).Conclusion The combined poisonous effects of fluorine and aluminum may influence sex hormone levels of male rats.

Objective:To evaluate the frequency and predictive factors of nipple involvement in a large contemporary cohort of pa-tients and to improve patient selection for the preservation of the nipple-areolar complex. Methods: This retrospective study re-viewed the medical charts of 1,190 patients who underwent traditional mastectomy in Peking University People's Hospital between October 2008 and March 2014. Nipple involvement incidence was compared between the cases of clinically abnormal and clinically normal breasts. Other clinicopathological features and nipple status were analyzed to evaluate the association between these factors and occult nipple involvement. Univariate and multivariate analyses were conducted to identify predictive factors. Results:Nipple in-volvement was detected in 6.0%of the mastectomy specimens. Meanwhile, incidence was 40.7%(22 out of 54) in clinically abnormal nipple cases and 4.3%(49 out of 1,136) in clinically normal nipple cases (χ2=121.9, P<0.001). Univariate analysis revealed that tumor lo-cation, tumor to nipple distance (≤2 and>2 cm), lymphovascular invasion, diameter (including carcinoma in situ;≤3.5 and>3.5 cm), T stage, N stage, and TNM stage were associated with occult nipple involvement. By logistic regression analysis, tumor location, tumor to nipple distance, T stage, and N stage were determined to be the independent predictors of nipple involvement. Conclusion:Clinical abnormalities of the nipples are reliable and potent predictors of nipple pathology. The cases with peripheral tumor, T1-T2 stage, and N0-N1 stage have lower probability of occult nipple involvement.

To discover novel antitumor fluoroquinolone lead compounds from a rational modification for antibacterial fluoroquinolones, a fused heterocyclic ketone corresponding to thiazolo[2,3- b][1,2,4]triazolone used as a bioisosteric replacement of the C-3 carboxylic acid group of ciprofloxacin 1, and further modification by a Claisen condensation reaction with substituted benzaldehydes formed novel fluoroquinolone C-3 fuse heterocyclic α, β-unsaturated ketones as the title compounds (6a-6r), separately. The structures of eighteen title compounds were characterized by elemental analysis, 1H NMR and MS, and the in vitro anti-proliferative activity against human hepatoma Hep-3B cells, pancreatic Capan-1 cells and leukemia HL60 cells was evaluated by a MTT assay. The preliminary results showed that the title compounds not only had more significant anti-proliferative activity against three tested cancer cell lines than that of the parent ciprofloxacin 1, but also exhibited the highest activity against Capan-1 cells. In particular, compounds carrying an electron-withdrawing carboxyl (6k, 6m) or sulfonamide substituent (6q, 6r) attached to benzene ring were comparable to or better than constractive drug doxorubicin against Capan-1 cells. As such, it suggests that it is favorable for a fused heterocyclic α, β-unsaturated ketone scaffold instead of the C-3 carboxylic acid group to improve the antitumor activity of fluoroquinolones.
Anti-Bacterial Agents ; Antineoplastic Agents ; chemical synthesis ; pharmacology ; Cell Line, Tumor ; Ciprofloxacin ; analogs & derivatives ; Fluoroquinolones ; chemical synthesis ; pharmacology ; HL-60 Cells ; Humans ; Ketones ; pharmacology ; Structure-Activity Relationship