Objective To investigate the expressions of cellular proliferative antigen (Ki-67)and androgen receptor (AR)in triple-negative breast cancer (TNBC)and their relationships with recurrence. Methods Sixty-six cases of TNBC and two hundred and fifteen cases of non triple-negative breast cancer (NTNBC)tissues between January 2006 and December 2010 in Jiangmen Hospital Affiliated to Sun Yat-sen University were collected,the expressions of Ki-67 and AR were detected by immunohistochemical,and through follow-up the relationships between TNBC recurrence and the expressions of Ki-67 and AR were analyzed.SPSS 19.0 was used to analyze the results.Results The positive rate of Ki-67 in TNBC (75.76%,50 /66)was significantly higher than that in NTNBC (62.33%,134 /215,χ2 =4.031,P =0.045),and Ki-67 expression was correlated with histological grade (χ2 =6.031,P =0.049),tumor diameter (χ2 =6.630,P =0.036)and lymph node metastasis (χ2 =5.440,P =0.020).The positive rate of AR in TNBC (31.82%,21 /66)was significantly lower than that in NTNBC (76.28%,164 /215,χ2 =44.382,P <0.001),and AR expression was correlated with menopausal status (χ2 =5.341,P =0.021 )and body mass index (χ2 =4.369,P =0.037).TNBC recurrence was related to Ki-67 expression (χ2 =4.125,P =0.042),and was not related to AR expression (χ2 =1.257,P =0.262).Conclusion High expression level of Ki-67 and low expression level of AR are characteristics of TNBC.Ki-67 positive patients are more likely to relapse,and it can be used as an indicator to predict TNBC recurrence.

Objective To evaluate the safety and feasibility of endoscopic ultrasonography(EUS)-guided dehydrated ethanol lavage on treatment of pancreatic cystic neoplasms(PCN). Methods The data of 15 patients with PCN treated by EUS-guided dehydrated ethanol lavage in Nanjing Drum Tower Hospital from April 2014 to December 2016 were retrospectively analyzed. All the patients underwent EUS-guided fine needle aspiration, and then the cyst cavity was lavaged with dehydrated ethanol. The curative effects and complications were evaluated after the procedure. Results Each patient had one operation and all the operations were successful. No operation-related intraoperative or postoperative complications occurred. Patients were followed up for a median time of 15 months(range from 3-30 months).Twelve patients finished a long term follow-up,including 6 cases of complete remission and 6 cases of partly remission. None of the patients underwent surgical resection. Conclusion Dehydrated ethanol lavage is safe and feasible for treatment of PCN.

Objective To evaluate the potential malignancy, prognosis and risk factors for intraductal papillary mucinous neoplasm(IPMN), which were classified into different risk levels based on Fukuoka guideline. Methods A retrospective analysis of patients with IPMN diagnosed at Nanjing Drum Tower Hospital from 2009 to 2016 was conducted. Clinical characteristics,treatment and prognosis of IPMNs were analyzed. Results A total of 94 IPMN patients were included and divided into 3 groups according to Fukuoka guideline,46 patients in high-risk(HR)group,30 in group of worrisome features(WF), and 18 in low-risk(LR)group. For patients undergoing surgery treatment, there were 5 cases(19.2%,5/26)in HR group and 2 cases(12.5%,2/16)in WF group whose postoperative pathological findings were malignant (P=0.690). The 5-year survival rates after operations were 73.9% and 77.0% in HR and WF group, respectively(P=0.830). For patients without surgery treatment, in a 5-year follow-up, there were 6 cases (33.3%,6/18),2 cases(16.7%,2/12)and 0(0.0%,0/18)progressing into pancreatic cancers in HR, WF and LR groups,respectively(P<0.05). In addition,among the three groups,the 5-year survival rates were 49.5%,85.7% and 100.0%(P=0.025). Jaundice was significantly related to prognosis(P<0.01) and the hazard ratio was 8.883(95%CI:2.953-26.721). Conclusion Jaundice is a predictive risk factor for survival of IPMN. As for the treatment to IPMN, patients in HR group should receive surgery treatment while those in LR group can be followed up. For patients in WF group,the treatment should be customized, with evaluation of predictive risk factors,and operations can be performed when needed.

OBJECTIVETo analyze the polio immunity level of persistent population in Beijing, 2012.

METHODSA total of 1 676 subjects residing more than 6 months in Beijing were selected by stratified random cluster sampling design in 2012. Demographic characteristics, history of oral poliovirus vaccine (OPV) immunization were investigated by questionnaire. All 5 ml blood sample were collected for testing of polio neutralizing antibody using the method of microcell neutralization. The positive rate and the geometric mean titer (GMT) of polio neutralizing antibody type I, II and III were analyzed in different groups.

RESULTSThe positive rate of type I, II and III were 98.2% (1 645/1 676), 98.1% (1 644/1 676), 97.6% (1 635/1 676); The GMT were 1:130.2, 1: 113.4 and 1: 79.7. Three types of positive rates in<15 years group (99.7% (664/666), 99.8% (665/666), 99.5% (663/666)) were higher than those of ≥ 15 years group (97.1% (981/1 010), 96.9% (979/1 010), 96.2% (972/1 010)), the differences were significant (all the values of P < 0.01); The GMT in<15 years group (1:325.9, 1:250.5, 1:190.7) were higher than that of ≥ 15 years group (1: 71.1, 1: 67.2, 1: 44.8), the difference was significant (all the values of P < 0.01). The positive rate (99.0%-100%) and GMT (1: 128.8-1: 300.7) in vaccination information confirmed population were higher. The highest positive rate (all were 100%) and GMT(1: 409.7-1: 636.7) were observed in children who vaccinated three times.

CONCLUSIONThe polio antibody of healthy population was at a high level in Beijing in 2012; Especially the age groups of < 15 years which were covered by vaccines.Immunization barrier had been formed firmly to interrupt the transmission of wild poliovirus and vaccine-derived poliovirus.

Adaptive Immunity ; Adolescent ; Antibodies, Neutralizing ; Antibodies, Viral ; Child ; Humans ; Poliomyelitis ; Poliovirus ; Poliovirus Vaccine, Oral ; Vaccination ; statistics & numerical data

Objective To investigate the effect of lycium barbarum polysaccharides (LBP) on apoptosis and autophagic death in primary cultured hippocampal neurons after oxygen glucose deprivation and reoxygenation (OGD/R) injury.Methods Primary cultured hippocampal neurons were exposed to OGD/R.The cells were randomly divided into 5 groups:control group,OGD/R group,and OGD/R+LBP groups (15,30 and 60 μg/mL LBP).The cell viability was assessed by MTT assay.The cell damage was evaluated through detecting the lactate dehydrogenase (LDH) release rate.Apoptosis rate was detected by TUNEL,and cleaved Caspase-3 was identified by immunofluorescence staining.Protein expression was detected by Western blotting.Results As compared with the control group,OGD/R group had significantly decreased cell viability (P＜0.05);and significantly increased cell viability and decreased LDH release rate were noted in the LBP (15,30 and 60 μg/mL) treatment groups as compared with those in the OGD/R group (P＜0.05).The 60 μg/mL LBP treatment group had significantly smaller number of TUNEL-positive cells than the OGD/R group(P＜0.05).Immunofluorescence staining and Western blotting both revealed that 60 μg/mL LBP treatment group had significantly decreased Beclinl level and ratio of cleaved Caspase-3/Caspase-3 and ratio of microtubule-associated protein light chain (LC)3 Ⅱ/LC3Ⅰ,and statistically increased p62 level and ratio of Bcl-2/Bax as compared with OGD/R group (P＜0.05).Conclusion LBP treatment protects primary hippocampal neurons from OGD/R injury via inhibiting apoptosis and autophagic cell death.

Objective:To analyze the costs and effectiveness of five common screening modes and genetic screening for thalassemia in China in order to find the optimal way and provide evidence for the implementation of thalassemia prevention and control projects in Hunan Province.Methods:From June 2020 to April 2021, 12 971 couples from 14 cities and autonomous prefectures in Hunan Province were selected as the study population. The diagnosis of thalassemia was based on the results of genetic testing. Results of routine blood test and hemoglobin electrophoresis were collected and analyzed. The efficacy of five screening modes, at the cut-off value of <80 fl or 82 fl for the mean corpuscular volume (MCV), was analyzed by positive predictive value, negative predictive value, Jorden index and cost-effectiveness ratio. Sensitivity analysis was used to assess the feasibility of genetic screening at different costs after fixing the costs of routine blood and hemoglobin electrophoresis. The five thalassemia screening models are as follows: Mode 1: The woman had a blood routine test first. If the result was positive, the spouse required a blood routine test. If both results were positive, a thalassemia gene test should be offered to the couple. Mode 2: Both husband and wife were screened by blood routine and hemoglobin electrophoresis. If one or both of them were positive, both would be tested for thalassemia gene. Mode 3: The couple received blood routine tests initially. If either was positive, both should receive hemoglobin electrophoresis testing. If either was positive, both parties will conduct thalassemia gene testing. Mode 4: The woman was screened by blood routine and hemoglobin electrophoresis. If any one of them was positive, the woman would be tested for thalassemia gene. If the gene test result was positive, the spouse should receive thalassemia gene. Mode 5: Both spouses conducted a blood routine test. If either was positive, both would conduct hemoglobin electrophoresis test. If both were positive, both spouses should receive thalassemia gene testing. Gene testing mode: The woman would be tested for thalassemia, and her spouse would have thalassemia test too if her result was positive.Results:When using MCV<80 fl as the cut-off for diagnosing thalassemia, the Youden indices of the five prenatal screening modes in Hunan Province were 0.551, 0.639, 0.898, 0.555 and 0.356, while when using MCV<82 fl as the cut-off, the Youden indices were 0.549, 0.629, 0.851, 0.548 and 0.356. When the MCV cut-off value was <80 fl, the missed diagnosis rates of the five screening modes were 44.44%, 0.00, 0.00, 18.52% and 62.96%, and the cost-effectiveness ratios were 21 709, 250 939, 76 870, 138 463 and 92 860 yuan (RMB)/couple, respectively. When the price of genetic testing was lower than 55 yuan (RMB), the cost-effectiveness ratio of genetic screening was lower than that of Mode 3.Conclusions:MCV<80 fl can be considered as the positive criteria in blood routine screening for thalassemia in Hunan Province, and the cost-effectiveness ratio of Mode 3 (the couple received blood routine tests initially. If either was positive, both should receive hemoglobin electrophoresis testing. If either was positive, both parties will conduct thalassemia gene testing) is the best. Genetic screening has certain advantages with the decreasing price.

Objective: Using data of health information system (HIS) of medical institutions to study the incidence and hospitalization of herpes zoster in three districts of Beijing. Methods: According to the different level of economic development and geographical features in Beijing, 3 districts of Xicheng, Changping and Miyun were chosen and all 110 medical institutions of the first level and above in the 3 districts are included in the survey. All the outpatient and inpatient herpes zoster cases in 2015 were retrospectively reviewed by HIS system. After distinguishing the reduplicated cases, Using the first outpatient case as a molecule and the resident population as denominator to estimate the annual incidence rate, as well as the annual hospitalization rate was estimated based on primary diagnostic hospitalized cases as molecule and the resident population as denominator. Results: A total of 32 313 primary visit outpatient cases were investigated, of which 18 360 cases (56.8%) were women and 20 923 cases (64.8%) were ≥50 years old. The overall estimated incidence of the 3 districts was 8.8‰ with an increase trends with age and reached to the highest in ≥80 years old (30.5/1 000). The incidence of Xicheng, Changping and Miyun districts are respectively 16.2‰, 4.0‰ and 5.7‰. A total of 701 primary visit inpatient cases were identified, of which 366 cases (52.2%) were women and 651 cases (92.9%) were ≥50 years old. The estimated annual hospitalization rate was 19.4/100 000, with the primary and secondary diagnostic hospitalization rate are respectively 5.9/100 000 (212 cases) and 13.5/100 000 (489 cases). The disease types of secondary diagnostic inpatient herpes zoster cases were as follows: cardiovascular disease (19.0%, 93 cases), stroke (14.5%, 71 cases), pneumonia/chronic obstructive pulmonary disease (14.1%, 69 cases), tumor (12.5%, 61 cases) and diabetes (5.7%, 28 cases). Conclusion Most of the herpes zoster cases in Beijing are over 50 years old, and the incidence of female is slightly higher than male. This disease should become a public health issue of great concern.

Background The association between serum nickel (Ni) and oral cancer incidence is unclear and most of the previous studies were observational studies that did not control for confounding factors between groups. Objective To assess the correlation of serum Ni with oral cancer incidence based on propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). Methods A cohort of 456 newly diagnosed oral cancer patients was recruited from the First Hospital of Fujian Medical University during November 2011 to May 2019, and residents ordered their health check-up in hospitals or local community health centers over the same period were selected as a control group, which included a total of 1410 participants. Serum Ni was evaluated by inductively coupled plasma mass spectrometry. Case-control pairs were selected using a 1:1 PSM (caliper value of 0.02), and the study subjects in the case group and control group were weighted for subsequent analysis by IPTW. The general characteristics of the study subjects were tested for equilibrium before and after matching by chi-square test and standardized mean difference (SMD). This was followed by exploring the potential nonlinear dose-response relationship between serum Ni and oral cancer using restricted cubic splines as well as analyzing the association between serum Ni and oral cancer incidence by conditional logistic regression and weighted logistic regression. Results After controlling for between-group covariates by PSM and IPTW, the dose-response curves demonstrated that the risk of developing oral cancer tended to decline and then increase with the increasing serum Ni level. The outcome of the analysis using PSM demonstrated that as compared to the control group, the risk of developing oral cancer in the 0.09-16.80 μg·L⁻¹ serum Ni group was negatively correlated with serum Ni level (OR=0.36, 95%CI: 0.24-0.54), whereas the risk of developing oral cancer in the >16.80 μg·L⁻¹ serum Ni group was positively correlated with serum Ni level (OR=5.43, 95%CI: 2.76-10.68). After applying IPTW, a negative association was found between the risk of oral cancer and serum Ni concentration within a serum Ni window ranging from 0.09 to 20.55 μg·L⁻¹ (OR=0.39, 95%CI: 0.29-0.52), while a positive association with an OR and 95%CI of 5.54 (3.62-8.49) for the Ni concentration > 20.55 μg·L⁻¹. Conclusion In this study, a J-shaped relationship between serum Ni concentration and the risk of developing oral cancer is found, which shows that high serum Ni concentration (>20.55 μg·L⁻¹) may be a risk factor for oral cancer.