PURPOSE: Near-infrared fluorescence imaging with indocyanine green (ICG) has the potential to improve sentinel lymph node (SLN) mapping in breast cancer. In this clinical trial, we compared the potential value of ICG combined with blue dye with that of blue dye alone for detecting SLNs. METHODS: Patients undergoing SLN biopsy (SLNB) between November 2010 and November 2013 were included. Up to December 2011, SLNs were detected by using patent blue (PB) alone, and since January 2012, by using PB in combination with ICG. The patients were divided into the following two groups: group A (ICG-PB; n=96) and group B (PB; n=73), and SLN detection parameters were compared between the groups. All patients underwent level I and II axillary dissections after SLNB. RESULTS: In group A, the SLN detection rate was 96.9% (93/96), the accuracy of detection was 98.9% (92/93), and the false-negative rate (FNR) was 3.4% (1/29). In group B, the SLN detection rate was 84.9% (62/73), the accuracy of detection was 96.8% (60/62), and the FNR was 11.1% (2/18). The ICG-PB group showed significantly superior results compared to the PB group for SLN detection (p=0.005) and a greatly improved FNR. CONCLUSION: The combined fluorescence and blue dye-based tracer technique was superior to the use of blue dye alone for identifying SLNs, and for predicting axillary lymph node status in patients with breast cancer; in addition, the combined technique had reduced false-negative results.
Biopsy ; Breast Neoplasms* ; Fluorescence ; Humans ; Indocyanine Green ; Lymph Nodes ; Optical Imaging* ; Sentinel Lymph Node Biopsy*

Objective To explore clinical classification and strategies for irreducible femur intertrochateric fractures.Methods A retrospective study was conducted of the 96 patients with irreducible intertrochanteric fracture who had been treated from January 2012 through December 2014 at our department.They were 47 men and 49 women,aged from 48 to 97 years (average,78.5 years).We classified the fractures according to location of fracture line and mechanism of fracture displacement into 5 types:13 cases of type Ⅰ (sagittal irreducible fracture),7 cases of type Ⅱ] (coronal irreducible fracture),72 cases of type Ⅲll (sagittal plus coronal irreducible fracture),zero of type Ⅳ (irreducible fracture involving the lesser trochanter),and 4 cases of type Ⅴ (irreducible fracture involving the greater trochanter).All the patients were managed using different techniques for closed reduction and fixation with proximal femoral nails antirotation Ⅱ.Results Of this series,limited open reduction was eventually conducted in 7.The operation time averaged 40 min;the amount of intraoperative blood loss averaged 200 mL.Fracture reduction was rated as grade Ⅰ in 78 cases and as grade Ⅱ in 18.The follow-up time averaged 16.6 months (from 12 to 24 months).All the fractures got united after an average of 5.8 months (from 3 to 9 months).The function of the affected hip was rated at the final follow-up using Harris scoring system as excellent in 79 cases and as good in 17,with an excellent to good rate of 100％.Refracture happened in one patient due to striking injury,urinary infection occurred in 2 patients and no wound infection was observed.Conclusion According to the classification and reduction strategy proposed by us,satisfactory reduction and fracture fixation can be achieved in management of irreducible intertrochanteric fractures.

Objective To explore the efficacy and safety of HAA regimen (homoharringtonine,cytarabine and aclarubicin) in the treatment of 150 newly diagnosed adult acute myeloid leukemia (AML).Methods All patients entered the study from May 1999 to June 2008 were treated with HAA regimen. Coxsurvival analysis was used to estimate the survival rate and differences between M1/M2 and M4/M5 were compared with 2-sided log-rank test. Results Out of the 150 patients, 121 (81%) achieved complete remission (CR). After the first course, CR rate was 68%. The CR rates of 97%, 84% and 38% were achieved in patients with favorable, intermediate and unfavorable cytogenetics, respectively. For the patients with CR, the median follow-up time was 16.5 ( 1.5-100.5 ) months, and the estimated 3-year survival rate was 45%. The estimated 3-year relapse free survival rate was 52% for the 121 patients with CR.Conclusions HAA regimen may be an efficacious and safe regimen with a good toleration in the induction therapy for newly diagnosed AML, and a high CR rate could be achieved with only one or two courses.

Objective To evaluate laparoscopic partial splenectomy (LPS) for benign splenic neoplasms.Methods From Sep 2016 to Aug 2017,7 patents with splenic benign lesions underwent laparoscopic partial splenectomy,results were compared with 15 cases receiving total splenectomy.Results All the patients underwent laparoscopic total or partial splenectomy successfully without conversion.There was no statistic difference in operative time,intra-operative blood loss and transfusion between the two groups.However,the morbidity of LPS group was significant lower (x2 =17.679,P =0.000),and no thrombocytosis occurred in LPS patients.Additionally,the patients received LPS recovered quicker and the postoperative hospital stay was shorter (5.7 ± 2.3) d vs.(15.3 ± 3.4) d (t =6.741,P =0.000 1) with a lower medical expenditure (19 288 ± 2 760) Yuan vs.(27 737 ± 4 626) Yuan (t =4.442,P =0.000 3).No thrombocytosis and recurrence were observed during follow up.Conclusions LPS is safe and effective to cure spleen benign lesions with quicker recovery and lower expenditure.

Objective To explore the temporal trend of cancer death rates in different age and the influencing factors in Kunshan,Jiangsu province,1981 to 2015.Methods Data were derived from cancer rcgistry and vital registration system.The Chinese age structure in 2000 was used to calculate age-standardized death rates (ASR),and annual percentage changes (APC) and 95％ confidence interval (Cl) were used to estimate the temporal trend of cancer death rates.Difference decomposition method was applied to analyze the contribution of demographic and non-demographic factors for the change of cancer mortality.Results Between 1981 and 2015,the age standardized all cancers death rate decreased from 162.49 to 93.74 per 100,000 (APC=-l.6％,95％ CI:-1.8％--1.5％).However,the ASR for those aged 70 years or above was stable over time (APC=0.2％,95％ CI:-0.2％-0.5％),whereas aged 30-69 years was decreased from 240.01 in 1981 to 93.28 in 2015 (APC=-2.8％,95％ CI:-3.0％--2.6％).In addition,the proportion of leading cancers were changed obviously.The proportion of lung cancer increased from 1981 to 2015,while gastric cancer,liver cancer,esophageal cancer and colorectal cancer decreased.Compared with the crude cancer mortality in 1993,the effect of the demographic and non-demographic factors to the increased death rate in 2015 were 308.93％ and-208.93％,respectively.Conclusion The ASR death rate of all cancers was decreasing,and the rate in those aged 30 to 69 years decreased significantly,whereas stable in those aged 70 years or above.The effect of demographic characteristics on cancer mortality was significantly greater than that of non-demographic characteristics.

Objective: To understand the epidemiological characteristics of influenza A(H1N1)pdm09 virus in Sichuan population during the monitoring period of 2018-2019, and to clarify the antigenic variation, the gene characteristics and the matching of current epidemic strains, vaccine strains, representative strains at home and abroad. Methods: A total of 118 strains of influenza A(H1N1)pdm09 virus isolated in Sichuan region influenza network laboratory from April 2018 to March 2019 were selected. The hemagglutination inhibition (HI) assay was conducted for antigen analysis. The HA and NA genes of 16 strains with low-response strains were sequenced. Phylogenetic analysis and amino acid locus variation analysis were applied using BioEdit and MEGA5.0 software. Results: The result of the antigen analysis demonstrated that more than 95% of the A(H1N1) pdm09 influenza viruses detected were similar to the WHO recommended vaccine strain A/Michigan/45/2015. The analysis of HA gene characteristics showed that some low-response strains had amino acid site variation in the Sa, Sb and Cb regions of the HA protein. A total of 15 low-response strains belonged to the 6B.1 branch. And their evolutionary relationship were close to the representative strains A/beijin-xicheng/SWL1633/2018 and A/brisbane/02/2018, which were popular at home and abroad. Compared with A/sichuan/1/2009, there are mutations involving 6, 14 and 1 amino acid sites in the antigen-determining regions (Sa, Sb, Ca and Cb), non-determined regions and receptor binding site(RBS) respectively. No amino acid site mutations related to resistance to NA gene were found. Conclusions In 2018-2019, the epidemic A(H1N1) pdm09 influenza virus in Sichuan is consistent with the global epidemic characteristics, which also matched with vaccine strains recommended by WHO in the northern hemisphere. Compared with A/sichuan/1/2009 which was the first isolated in China in 2009, there were amino acid sites mutations in antigen-determining region and receptor binding site of the HA protein, and the transmembrane region of the NA protein, drug and antibody binding sites.

Objective To investigate genetic characteristics of Coxsackie virus B5 (CVBS) in acute flaccid paralysis(AFP) cases in Sichuan Province.Methods 10 CVB5 strains isolated from stool samples of AFP cases in Sichuan Province over 2007-2014 were subjected to entire VP1 coding region amplification by reverse transcription-polymerase chain reaction (RT-PCR) and nucleotide sequencing,and phylogenetic tree was constructed for genetic characterization.Results All of the 10 strains were identified as genogroup D.The nucleotide and the amino acid homologies were 80.4％-81.9％ and 95％-97.1％,which compared with the Faulkner prototype strain.The amino acid homologies between Ziyang strain and Chengdu strain obtained in 2014 were 100％,respectively.The nucleotide and the amino acid homologies between Nanchong isolate and Yibin isolate obtained in 2014 were both 100％,respectively.Conclusions The isolates from AFP cases in Sichuan Province over 2007-2014 were belong to genogroup D.The genetic characteristics of 10 strains were stable.

Objective To investigate the levels of antibody to measles,rubella and mumps viruses in healthy population in Sichuan province,2018.Methods Totally 1 901 healthy people were selected from 7 age groups in 9 counties of Sichuan province.Serum samples of them were collected to test the IgG antibody to measles,rubella and mumps viruses by enzyme-linked immunosorbent assay (ELISA),and analyzed statistically.Results In 1 901 subjects,the positivity rates of measles,rubella and mumps IgG antibody were 83.69％,71.59％,63.12％ respectively,and the geometric mean titer (GMCs) were 1 289.92 mIU/ ml,87.63 IU/ml,and 425.62 U/ml respectively.There were significant differences in positivity rates of measles,rubella and mumps antibody among age groups and counties.There were no significant differences in GMCs of measles antibody among age groups and among counties,and the samples with full protection of measles (GMC≥ 1 000 mIU/ml) accounted for only 34.19％.There were significant differences in GMCs of rubella and mumps antibody among age groups and among counties.Conclusions The levels of antibody to measles,rubella and mumps were lower in healthy population in Sichuan.Vaccination should be strengthened in vulnerable areas and age groups.

Objective To analyze the hotspots and developments in the field of language model-assisted artificial intelli-gence(Al)for antibody design and optimization in order to provide reference for research on development of antibodies.Methods By using CiteSpace software,hotspots of research were analyzed based on literature retrieved from the Web of Science,PubMed,and Scopus databases,focusing on three pivotal areas of research related to antibody design and optimization:the construction of pre-trained language models for antibodies,the generation of antibody sequences,and the prediction of three-dimensional structures of antibodies.In addition,this analysis reviewed the major advances in each of the specified research tasks,focusing on the delineation of similarities and differences across studies and dominating challenges in this field.Results From 2019(10 publications)to 2023(89 publications),the scale of and interest in this field kept increasing.Hotspots involved leveraging language models to assist the design or optimization of humanized,high-affinity,and highly specific antibodies.Within each research,methods were characterized by the diversity of model architectures,consistency of training data,and variations in training strategies.Challenges to the field included sparse antigen data,computational power limitations,and insufficient integration of wet and dry lab experiments.Conclusion Research in language model-assisted Al antibody design and optimization is gaining momentum and proves fruitful.However,researchers should be alert to the inadequate attention to antigen-antibody interactions and insufficient integration of experimental and computational validation,conduct more in-depth research and expand applications.

Objective To estimate the dose response relationship between cigarette smoking and hypertension in men based on restricted cubic spline method.Methods Under the proportion to the population size,38 520 subjects were randomly selected from May to August 2012 with cluster sampling method in urban and rural areas of Kunshan,China.Each participant received face-to-face interview with the standardized questionnaire,and physical examination.Restricted cubic spline was employed to estimate the dose response relation of cigarette smoking on the risk of hypertension.Results The overall prevalence of cigarette smoking was 22.6％ (8 691/38 520),prevalence of cigarette smoking in men was 46.1％ (8 499/18 454).Multiple logistic regression analysis showed that current smoking (OR =1.16,95％ CI:1.05-1.28) and previous cigarette smoking (OR =1.32,95％ CI:1.07-1.63) were associated with hypertension after adjusted confounding factors (age,sex,body mass index,education,family income per month,urban or rural areas,physical activity and physical exercise) in men.After further adjusting drinking status,only previous cigarette smoking was associated with hypertension (OR =1.28,95 ％ CI:1.04-1.58).The restricted cubic spline model indicated a linear dose-response relation between hypertension and cigarette smoking per day in men (non-linearity test P =0.604 1).However,a non-linear dose response relation was found between duration of smoking (non-linearity test P ＜ 0.000 1),smoking index (non-linearity test P =0.009 9) and hypertension.Conclusion Long-term and heavy cigarette smoking is associated with hypertension in men.