Objective To improve the diagnostic accuracy of nonpalpable calcified breast lesions by establishing a Logistic multivariate prediction model to assess the probability of benign/malignant breast lesions.The proposed model is based on the clinical and BI-RADS-X-ray imaging features of patients with nonpalpable calcified breast lesions.Methods A total of 147 nonpalpable calcified breast lesions were analyzed retrospectively.Firstly, based on the personal experience,the X-ray imaging data of lesions were analyzed to obtain the BI-RADS categorization, and the ROC curve was plotted by comparison with pathology.Then the univariate and multivariate analysis was performed on the clinical and X-ray imaging features of pathology to select the independent factors related to benign/malignant features.Further,a Logistic regression model was built,the suitable cut-off point was determined, and the ROC curve was obtained.Finally,the comparisons of the diagnostic accuracy of breast lesions were made between the method using the BI-RADS categorization and the method using the Logistic regression model.Results The AUC of the BI-RADS method was 0.867 9.The univariate analysis showed that there exist statistical differences among clinical features of patients(age,location,and quadrant),as well as the BI-RADS-X-ray imaging features (distribution,morphological and gland density).Also,by using the multivariate Logistic regression equation,the statistical differences among age,quadrant and morphological difference can be observed.The AUC using the built Logistic regression model was 0.906 3.Conclusion The diagnostic accuracy of breast lesions using the Logistic model is higher than that using the BI-RADS categorization method.Therefore, the proposed model is valuable for obtaining accurate diagnosis of breast lesions.

Objective To assess the value of diffusion weighted imaging (DWI) in monitoring therapy effect of neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer.Methods The prospective study included 26 lesions in 24 patients with LABC undergoing NAC.MRI was conducted before chemotherapy,after the first cycle of chemotherapyand after all cycles,including conventional MRI and DWI.All patients were confirmed by pre-treatment fine needle aspiration biopsy (FNAB),and postoperative histopathological prout.All lesions were divided into two groups of pathological complete response (pCR) and non-pCR.We evaluated ADC value and its changes in pathological complete response difference between the groups and complete remission in each testing point.Results Before chemotherapy and after the first cycle of chemotherapy,the ADCmean andADCmin had no statistically significant difference hetween pathologic complete response group and non-complete remission.After the whole chemotherapy,both of them had statistically significant difference;pathological complete response (pCR) and non-pCR early ADCmin value rate were (16.78 ± 22.70) ％ and (12.37 ± 10.09) ％respectively.No statistically significant difference was seen (P =0.53).Preoperative ADCmin value rates were (91.41 ± 45.83) ％ and (29.74 ± 22.96) ％ respectively,which were statistically significant (P =0.00) Conclusion ADC which is measured from DWI can be used to assess early response to NAC in breast cancer lesion,but cannat predict pCR or non-pCR for all cycles of chemotherapy on the first cycle.

Objective To investigate the diagnostic value and therapeutic implication of breast imaging reporting and data system (BI-RADS)in non-palpable breast lesions detected by imaging.Methods 21 7 patients,who were found clinical non-palpable suspi-cious lesions in breast by X-ray examination,were enrolled in our study.All patients underwent general mammography (including craniocaudal view and mediolateral oblique view)and mammographic spot view in some patients,then were biopsied using 3D wire guided location biopsy.The predictive value of BI-RADS was analyzed by compare the imaging diagnosis with pathological results. Results Of the 21 7 cases,98 cases were diagnosed of grade Ⅲ,81 cases of grade Ⅳ and 38 cases of grade Ⅴ using BI-RADS.All cases were confirmed by surgery.All lesions were excised completely according to the preoperative 3D wire guided location biopsy. 75 lesions were malignant (34.6%,75/21 7),including 39 cases of carcinoma in situ (52.0%,39/75);142 lesions were benign.1 1 cases of grade Ⅲ,29 cases of grade Ⅳ and 35 cases of grade Ⅴ were malignant.The positive predictive value of BI-RADS for gradeⅢ,grade Ⅳ and grade Ⅴ was 1 1.2% (1 1/98),35.8% (29/81)and 92.1% (35/38)respectively.The positive predictive value of BI-RADS Ⅳ for premenopausal and postmenopausal women was 24.5% (13/53)and 57.1% (1 6/28).Conclusion BI-RADS can improve the resection rate and biopsy rate of non-palpable breast lesions by 3D wire guided location biopsy,and the detection rate of early breast cancer.

Objective:The present study aimed to investigate the short-term efficacy and adverse effects of induction chrono-che-motherapy including docetaxe1 (TXT), cisplatin (DDP), and 5 fluorouraci1 (5-FU) followed by concomitant chemoradiotherapy in lo-co-regionally advanced nasopharyngeal carcinoma (NPC). Methods:Newly diagnosed locally advanced (Ⅲ~Ⅳb) NPC patients were enrolled in this study. All patients received three cycles of TPF regimen. The TPF chemotherapy regimen was administered as follows:TXT, 75 mg/m2, i.v. infusion, d1; DDP, 75 mg/m2, bolus infusion from 10:00 to 22:00, d1-5; and 5-FU 750 mg/m2/d bolus infusion from 22:00 to 10:00, d1-5, with 21 days each cycle, followed by concomitant IMRT and chemotherapy (paclitaxel 135 mg/m2 i.v. infu-sion, with 21 days each cycle and a total of 2 courses). Acute and late toxicities were graded according to the Common Terminology Cri-teria for Adverse Events v3.0 scoring criteria. Tumor response was evaluated using 2000 Response Evaluation Criteria in Solid Tumors criteria. Results:The CR and PR rates of induction chemotherapy were 23.8%and 68.6%, respectively;whereas the CR and PR rates of the combined modality treatment were 64.8%and 31.4%, respectively. Two-year overall survival rate was 91.4%, two-year progres-sion free survival rate was 87.0%, and two-year distant metastasis-free survival rate was 88.4%. The main side effects from induction chemotherapy include an over grade 3 granulocytopenia of 28.6%. Major toxicity from concurrent chemo-radiotherapy was oral mucosi-tis (81.0%);grade 3 to 4 oral mucositis was 16%. No treatment-related deaths occurred in this study. Conclusion:Induction chrono-che-motherapy using TPF followed by concurrent chemoradiotherapy of paclitaxel is a well-tolerated treatment with short-term efficacy and severity for locally advanced NPC. Further follow-up is required to assess the late effects and long-term efficacy.

Objective To evaluate the tonic and health effects of Xuebijing injection,a traditional Chinese medicine injection,by means of corn low-nutritional mice model combined with benefit-damage index-general score (BDI-GS) evaluation system under a physiological dosage.Further,to investigate the scientific and practical benefits of the evaluation system in efficacy and safety re-evaluation of clinical traditional Chinese medicine injections.Methods Healthy ICR mice during growth period were randomly divided into blank control group and low,middle and high dose groups.All the mice were fed with corn diets,and treated by intraperitoneal injection once a day.The mice in the blank control group were injected with 0.4 ml 0.9％ sodium chloride injection,and the mice in the low,medium and high dose groups were injected with 0.2,0.4 and 0.6 ml Xuebijing injection,respectively,for seven days.On the 8th day,the mice were killed,dissected,and took nine kinds of organs including heart,lung,thymus,spleen,pancreas,kidney,gonad and femur.The weight BDI,index BDI and the corresponding weight BDI general score (GSw) and index BDI general score (GSI) were calculated,and the serum biochemical parameters were measured.Results Under the physiological dose,Xuebijing injection shows good safety of continuous infusion,tonic and health effects,and slight damages on the rest of organs.More specifically,the values of weight BDI and index BDI were all higher than 9.0,and values of GSw and GSI were all higher than the basic value of 9.0.Furthermore,these parameters increased in a dose-dependent manner.In addition,the total protein level of (47.6 ± 4.30) g/L in the high dose groups was significantly higher than (43.18 ± 2.60) g/L in the blank control group (P＜0.05).Conclusions The Xuebijing injection has a lower risk for conventional usage.This injection is safe under the physiological dosage and much safer in higher dosage designed in this study.The low-nutritional model combined with BDI-GS evaluation system can be used for re-evaluating the function and safety of clinical traditional Chinese medicine injections.

Objective To evaluate the clinical effect of endoscopic retrograde biliary drainage (ERBD) and endoscopic naso-biliary drainage (ENBD) on hilar cholangiocarcinoma (HACC).Methods The clinical data of 87 patients with HACC,who underwent ERBD and ENBD form January 2010 to January 2016,were retrospectively analyzed.The incidence of postoperative severe cholangitis,biliary obstruction again within 4 weeks,reduction of total bilirubin and survival time were studied.Results There were significant differences between ERBD group and ENBD group on the incidence of severe cholangitis[29.2％ (14/48) VS 10.3％ (4/39),x2 =4.689,P=0.030] and bile duct obstruction in 4 weeks after operation [47.9％ (23/48) VS 23.1％ (9/39),x2=5.710,P =0.017].The total bilirubin within 2 weeks and 4 weeks postoperatively was significantly reduced compared with that before operation (P＜0.05).There was no statistical difference in descend range of total bilirubin between the two groups.There was significant difference between ERBD group and ENBD group in the median survival time [14 weeks (range,0-60 weeks) VS 34 weeks (range,2-96 weeks),x2 =10.101,P=0.010].Conclusion Compared to ERBD,ENBD has certain advantages on palliative care for HACC.

Objective To construct the Hut78 cell line with EZH2 gene knocked into by CRISPR/Cas9 system. Methods The EZH2 expression vector pMD-18T-EZH2 with homologous arm and the sgRNA expression vector pSpCas9 (BB)-2A-Puro-sgRNA, which could cut the double stranded genomic DNA, were constructed, and the two vectors were co-transfected into Hut78 cells. Then the expression of EZH2 mRNA was detected by qPCR, and the expressions of EZH2 and H3K27me3 proteins were detected by Western blot assay. Results The pMD-18T-EZH2 and pSpCas9(BB)-2A-Puro-sgRNA recombinant vectors were confirmed by DNA sequencing. When Hut78 cells were transfected with the two recombinant plasmid, qPCR results showed that the expression of EZH2 mRNA was significantly increased, and Western blot analysis showed that the expressions of EZH2 and H3K27me3 proteins were significantly increased. Conclusion EZH2 gene is successfully knocked into Hut78 cells by CRISPR/Cas9 system.

PURPOSE: This study aimed to identify potential epidermal growth factor receptor (EGFR) gene mutations in non-small cell lung cancer that went undetected by amplification refractory mutation system-Scorpion real-time PCR (ARMS-PCR). MATERIALS AND METHODS: A total of 200 specimens were obtained from the First Affiliated Hospital of Guangzhou Medical University from August 2014 to August 2015. In total, 100 ARMS-negative and 100 ARMS-positive specimens were evaluated for EGFR gene mutations by Sanger sequencing. The methodology and sensitivity of each method and the outcomes of EGFR-tyrosine kinase inhibitor (TKI) therapy were analyzed. RESULTS: Among the 100 ARMS-PCR-positive samples, 90 were positive by Sanger sequencing, while 10 cases were considered negative, because the mutation abundance was less than 10%. Among the 100 negative cases, three were positive for a rare EGFR mutation by Sanger sequencing. In the curative effect analysis of EGFR-TKIs, the progression-free survival (PFS) analysis based on ARMS and Sanger sequencing results showed no difference. However, the PFS of patients with a high abundance of EGFR mutation was 12.4 months [95% confidence interval (CI), 11.6−12.4 months], which was significantly higher than that of patients with a low abundance of mutations detected by Sanger sequencing (95% CI, 10.7−11.3 months) (p < 0.001). CONCLUSION: The ARMS method demonstrated higher sensitivity than Sanger sequencing, but was prone to missing mutations due to primer design. Sanger sequencing was able to detect rare EGFR mutations and deemed applicable for confirming EGFR status. A clinical trial evaluating the efficacy of EGFR-TKIs in patients with rare EGFR mutations is needed.
Adenocarcinoma/genetics ; Adenocarcinoma/pathology ; Aged ; Aged, 80 and over ; Animals ; Base Sequence ; Disease-Free Survival ; Female ; Humans ; Lung Neoplasms/genetics ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Mutation/genetics ; Mutation Rate ; Real-Time Polymerase Chain Reaction/methods ; Receptor, Epidermal Growth Factor/genetics ; Sequence Analysis, DNA/methods ; Treatment Outcome

Objective To investigate the MRI features and characteristics of irregular intraductal papilloma (IDP)and invasive ductal carcinoma (IDC),and to improve the diagnostic accuracy of MRI.Methods This study retrospectively included 3 3 patients with IDP and IDC confirmed by surgery and pathology,and analyzed MRI findings including lesion size,boundary,internal components,plain signal intensity,enhancement mode,ADC value and TIC curve χ.2 test,t test and rank-sum test were performed.Results Compared with the two groups,lesion boundary (P＜0.001),size (P＜0.001 ),ADC value (P＜0.001 ),enhancement mode (P＝0.001 ),TIC curve peak time (P＜0.001),slope (P＜0.001)and peak enhancement rate (P＜0.001)were statistically significant (P＜0.05);lesion (P＝0.159), internal components (P＝0.778),T2 WI signal (P＝0.438)and curve type (P＝0.406)were no statistically difference.Conclusion The irregular mass type IDP and IDC have similar MRI findings,the edge of the lesion,the ADC value,the enhancement mode,and the peak time,slope and peak enhancement rate of the curve are important for the identification of the two diseases.

OBJECTIVETo compare the short-term efficacy and observe the tolerability and safety of recombinant human endostatin combined with induction chemotherapy followed by chemoradiotherapy for locally advanced nasopharyngeal carcinoma.

METHODSFifty-three patients with locally advanced nasopharyngeal carcinoma, who received recombinant human endostatin combined with induction chemotherapy followed by chemoradiotherapy, treated in our department from December 2011 to March 2013 were included in the study group of this study. Another 48 patients, who received induction chemotherapy followed by chemoradiotherapy alone in the same period, were chosen as a control group. The short-term outcome, overall survival (OS), progression-free survival (PFS), and acute side effects of the two groups were compared.

RESULTSThe complete remission rates of nasopharyngeal tumor in the study and control groups were 77.4% and 72.9%, respectively (P=0.154). The complete remission rates of patients with and without cervical lymph node metastasis were 75.5% and 62.6%, respectively, showing a significant difference (P=0.037). The 2-year OS, PFS, and DMFS rates for the study group were 82.3%, 77.2%, and 82.2%, respectively, versus 87.2%, 84.3% and 84.2% for the control group, showing a non-significant differences between the two groups (P=0.938, P=0.551, and P=0.725).

CONCLUSIONSThe short-term results of recombinant human endostatin (Endostar) combined with induction chemotherapy followed by concurrent chemoradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma are slightly better than that of induction chemotherapy followed by concurrent chemoradiotherapy alone, with tolerable treatment-related toxicity and no more side effects.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma ; Chemoradiotherapy ; Cisplatin ; Disease-Free Survival ; Endostatins ; therapeutic use ; Humans ; Induction Chemotherapy ; Lymphatic Metastasis ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; Remission Induction