OBJECTIVEThe phosphatidylinositol-3-kinase (PI3K)-AKT signaling pathway is considered to play an important role in tumorigenesis. Frequent somatic mutations in the PI3K subunit p110a (PIK3CA) occur in a variety of cancer types. The purpose of this study was to determine the relationship between PIK3CA mutation in breast cancer and pathological features and outcome of patients.

METHODSThe PIK3CA mutations in exons 7, 9, 20 were screened in 250 primary breast cancers using PCR and fluorescent (F)-SSCP, and the results were analyzed according to their cliniopathological data.

RESULTSThe frequency of PIK3CA mutations among the 250 cases was 35.2% (88/250), point mutations in exon 7 were found in 8 (3.2%) cases,40 (16.0%) cases in exon 9 and 47 (18.8%) cases in exon 20. No significant correlation between PIK3CA mutation and age, histological type, differentiation, and lymph node metastasis was observed. Mutations were associated with larger tumor size (P = 0.004) and positive estrogen receptor status (P = 0.008). Patients with PIK3CA mutations showed a significantly worse survival (P = 0.004), particularly in those with positive estrogen receptor expression or non-amplified HER-2 (both P = 0.002).

CONCLUSIONSPIK3CA mutations may play an important role in the carcinogenesis and development of breast cancer. The association with large tumor size, ER+ and poor survival indicates that PIK3CA mutation could be an independent factor for tumor malignant phenotype and prognosis.

Adenocarcinoma ; genetics ; metabolism ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; genetics ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; genetics ; metabolism ; pathology ; Carcinoma, Lobular ; genetics ; metabolism ; pathology ; Carcinoma, Medullary ; genetics ; metabolism ; pathology ; Class I Phosphatidylinositol 3-Kinases ; Exons ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Middle Aged ; Phosphatidylinositol 3-Kinases ; genetics ; metabolism ; Point Mutation ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Survival Rate ; Tumor Burden ; Young Adult

Objective To observe the effects of aerobic training and aerobic combined with resistance training on motor function, like muscle strength,cardiopulmonary endurance and so on,in patients with chronic kidney disease(CKD). Methods From July,2015 to August,2016,60 patients with CKD were randomly divided into control group(A,n=20), aerobic training group(B,n=20)and aerobic combined with resistance training group(C,n=20).Group B per-formed cycle ergometer at 50% peak oxygen uptake(VO2peak)for 30 minutes a time,and group C performed one section of Thera-Band resistance training based on group B, three times a week for twelve weeks.All patients were evaluated with one repetition maximum-upper limb (1 RM-U), one repetition maximum-lower limb (1 RM-L),Cardiopulmonary Exercise Test(CPET),Arm Curl Test(ACT),30-second Chair Stand(CS-30),Six-Min-ute Walk Test(6MWT),and estimated gomerular filtration rate(eGFR)and serum creatinine(sCr)were calculat-ed and recorded before and after training. Results There was no significant difference in all indexes among three groups before training(F<1.841,P>0.05).After training,all indexes improved in groups B and C(t>2.162,P<0.05),and were better in groups B and C than in group A(t>2.132, P<0.05).After training, 1 RM-U, 1 RM-L, VO2peak,ACT, CS-30 and 6MWT were better in group C than in group B(t>2.081,P<0.05). Conclusion Aerobic training could improve the motor function of patients with CKD,and it is more effective combined with resistance training.

Cloning, Molecular ; Escherichia coli ; genetics ; Hepacivirus ; genetics ; Humans ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; immunology ; Viral Nonstructural Proteins ; biosynthesis ; genetics ; immunology

The spinal manipulation in traditional Chinese medicine (TCM) has a prominent clinical advantage in the treatment of chronic lumbar pain,such as low back pain,but the insufficient basic research on manipulation is a serious obstacle to its development.Using finite element analysis (FEA) can preferably simulate the mechanics under various kinds of spinal manipulation,analyze its action mechanism,test the hypothesis,standardize the operating practices,make quantitative,qualitative and optimal treatment plans,so as to provide an effective method for the basic research on manipulation therapy.This paper reviews the FEA studies of spinal manipulation in recent years,discusses the influence of different spinal manipulation on intervertebral disc,lumbar accessory structures,spinal loads and mechanical stability of the vertebral body.The results show that current FEA studies on spinal manipulation need to make the simulation method standardized and precise.Meanwhile,the research ideas of finite element method should be developed to guide the clinical application of spinal manipulation.

OBJECTIVETo describe the characteristics and factors associated with long-term retention for methadone maintenance treatment (MMT) patients.

METHODSThis study was conducted in eight MMT clinics located in Sichuan, Yunnan, Guangxi, Guizhou and Zhejiang provinces. Five hundred and thirty-nine MMT patients who enrolled in MMT clinics in 2004 and retained in treatment by June 2010 were selected as study subjects. Chi-square tests were used to compare the demographics and drug abuse history at enrollment and treatment characteristics during the follow-up period between continuous treatment patients and discontinuous treatment patients.

RESULTSOf the 539 patients, 110 (20.4%) were continuous treatment patients whereas 429 (79.6%) were discontinuous treatment patients. Of these 429 discontinuous treatment patients, 84.1% (361/429) had 2-4 treatment episodes whereas 15.9% (68/429) had 5 or more episodes during follow-up period. When continuous treatment patients were compared with discontinuous treatment patients, living with family members or friends (88.2% (97/110), 78.5% (337/429)), age of first drug use under 25 (61.8% (68/110), 71.3% (306/429)), low urine morphine positive test results (67.3% (74/110), 38.2% (164/429)) and living within 5 kilometers of the MMT clinic (72.7% (80/110), 61.3% (263/429)) were positively associated with higher possibility of continuous treat retention (P < 0.05). Demographics and drug abuse characteristics at enrollment, including gender, age, employment status, family relationship, injection, needle sharing, criminal behavior, contacts with drug users, MMT daily dosage and family members receiving MMT were not significantly associated with treatment retention (P > 0.05).

CONCLUSIONIllicit drug use during the treatment and longer distance travelling to MMT clinic might have negative impact on patients' continuous treatment retention. Mobile MMT vehicles and expanded MMT service sites could be introduced to improve compliance of treatment retention of MMT patients.

Adult ; Female ; Humans ; Longitudinal Studies ; Male ; Methadone ; administration & dosage ; therapeutic use ; Patient Compliance ; statistics & numerical data ; Substance-Related Disorders ; drug therapy ; Treatment Outcome

OBJECTIVETo evaluate the feasibility and effectiveness of needle and syringe exchange program among a community of injecting drug users (IDUs) on AIDS prevention.

METHODSA quasi-experiment design was used in a controlled community intervention study. Needle and syringe exchange program was implemented for 10 months in IDUs of an intervention community, including peer education and health education, provision of free needles and syringes, and collecting back of used needles and syringes by trained peer educators and local health workers, whereas no intervention measure in a control community was instituted. Interviews with IDUs were conducted before and after intervention with a snowballing strategy to evaluate its effectiveness.

RESULTSA total of 428 and 429 IDUs were interviewed with structured questionnaire before and after intervention in intervention and control communities, respectively. Results revealed that awareness of HIV-related knowledge increased from 29.4% to 58.7% in the intervention community. Multivariate logistic regression analysis showed that awareness of HIV-related knowledge was higher in those who had read health education materials (OR = 2.93, 95% CI 2.12 - 4.04). As compared with the baseline data, frequency of sharing needles and syringes in past 30 days in the intervention community decreased from 48.9% to 20.4% in before intervention community (chi(2) = 41.02, P = 0.001), whereas there was no significant change in the control community. The causes of sharing needles and syringes in the intervention community included 'disable to get needle and syringe during the night', 'lack of needle and syringe when injecting at friend's home', 'not daring to buy needle and syringe for fear of being arrested' and 'no money to buy needle and syringe', declined markedly.

CONCLUSIONSNeedle and syringe exchange program was feasible and effective in reducing their risky drug injecting behavior among IDUs in communities. Such strategy should be adopted in the country to reduce rapid spread of HIV.

Adult ; China ; epidemiology ; Female ; HIV Infections ; prevention & control ; transmission ; Health Education ; Humans ; Male ; Needle Sharing ; adverse effects ; statistics & numerical data ; Needle-Exchange Programs ; economics ; organization & administration ; Pilot Projects ; Program Evaluation ; Substance Abuse, Intravenous ; complications ; epidemiology

OBJECTIVE: To evaluate the satisfaction and performance of water colonoscopy and gas colonoscopy. METHODS: 240 continuous cases were randomly divided into two groups(gas colonoscopy group, water colonoscopy group). Record the general condition, success rate, period of performance and abdominal pain score. Investigate the degree of abdominal pain, distension and the will of receiving anesthetic colonoscopy next time in the follow-up. RESULTS: There were no significant difference between two groups in the general condition, success rate, depth of insertion, abdominal pain after examination or the will of receiving anesthetic colonoscopy next time(P>0.05). The period of insertion, period of withdrawal and period of performance in water colonoscopy group was longer than those in the gas colonoscopy group(P<0.001, P=0.013, P<0.001). The degree of abdominal distension at 1 hour after colonoscopy in water colonoscopy group was higher than those in the gas colonoscopy group(P<0.001), but no significant difference was found at6 hours after examination. CONCLUSION: Patients undergoing water colonoscopy have better outcomes with less abdominal pain and abdominal distension except for longer time of performance.

OBJECTIVETo evaluate the diagnostic value and safety of percutaneous lung biopsy in hematologic patients with lung infection.

METHODS28 cases hematologic patients received CT-guided percutaneous lung biopsy when they developed a fever associated with pulmonary nodules or lumps in CT scan whose clinical diagnosis were unclear during or after chemotherapy. Sample of each lesion were drawn twice. The lung tissue was re-scanned after lung biopsy to check up in order to discover bleeding and pneumothorax. Biopsy tissue was examined by bacteria culture, acid-fast staining and pathology. Pathological examination contained HE staining, acid-fast stain, PAS stain, TB-DNA, methenamine silver and others.

RESULTS28 cases contain 24 males and 4 females. Median age was 40 15 - 77 years old. Blood tests were as follows: 3 cases with HGB > 110 g/L, 9 with HGB 90 - 110 g/L, 12 with HGB 60 - 89 g/L, 4 with HGB < 60 g/L. 8 with WBC > 10×10(9)/L, 6 with WBC (4 - 10)×10(9)/L, 13 with WBC < 4×10(9)/L, 1 with WBC < 2×10(9)/L; 14 with PLT > 100×10(9)/L, 5 with PLT (50 - 100)×10(9)/L, 5 with PLT < 50×10(9)/L, 4 with PLT < 30×10(9)/L. 4 cases had mild extended PT, 3 mild extended APTT, 3 FIB lower than normal. Lung CT scans were as follows: 4 cases with simply lesion in right lung, 4 with simply lesion in left lung, 20 with lesions in bilateral lung. 8 cases were diagnosed as fungal infection, 3 as tuberculosis infection, 1 as lung cancer, 1 as pulmonary infiltration of lymphoma, 1 as pulmonary infiltration of leukemia, and 14 as inflammatory changes with no specific diagnosis. 4 cases came with pneumothorax during lung biopsy, mild to moderate in 3 cases and severe in 1 case. Severe patient turned better after CT-guided suction. 3 cases with mild hemoptysis turned better after treatment.

CONCLUSIONWhen hematopathy patients are with pulmonary nodules or lumps in CT scan whose clinical diagnosis is unclear, CT-guided percutaneous lung biopsy is safe and conducive to early diagnosis and conducive to early rehabilitation of patients if the coagulation function is basically normal and platelet count is not too low.

Adolescent ; Adult ; Aged ; Biopsy ; Female ; Hematologic Diseases ; microbiology ; pathology ; Humans ; Lung ; pathology ; Male ; Middle Aged ; Pneumonia ; diagnosis ; Young Adult

Objective To determine the proportion of heroin use among patients who were involved in community-based methadone maintenance treatment (MMT) program and to identify the risk factors associated with heroin use. Methods This study was conducted in 9 MMT clinics within 3 provinces. Thirteen hundred and one patients who met the study criteria were selected from each of the five groups with different dosages of methadone users. An administrative questionnaire was applied to explore the demographics,drug abuse-related behaviors and MMT services received by the clients,etc. The prevalence of depression and anxiety among the clients were also collected by SAS and SDS. Urine samples were collected as a biological marker to indicate if heroin had been used. Results Of the 1301 patients,76.2% were males. The mean age was (34.6±6.5) years while 71.7% had an education level of primary school or below. The average daily dosage of methadone was (48.1±29.4) mg and self-satisfied evaluation score on treatment was 8.6. On average,27.7% urine samples showed positive opiate evidence. Marital status,employment status,treatment retention,self-satisfied evaluation score on dosage and dropout history were found to be significantly associatedwith heroin use,while gender,education level and dosage had no significant association with heroin use. It seemed that risk factors that associated with heroin use were different from areas to areas. Conclusion High quality MMT clinic services,high self-satisfied score,longer treatment retention and low dropout rate seemed to have the effects of reducing the risk of ongoing heroin abuse under the methadone maintenance treatment program.

Objective To evaluate the long-term effectiveness of the first set 8 methadone maintenance treatment (MMT) clinics in China. Methods Repeated cross-sectional surveys were conducted on the first month after the enrollment and 5 years later,among drug users who received MMT,using a standard questionnaire.Data on demographic characteristics,HIV-related high-risk bchaviors,criminal records associatcd with drug use and related family/social functions were collected and analyzed.Results There were 252 and 195 participants being interviewed at the baseline and the 5-year surveys,respectively,.Of them,66 participants were involved in both surveys.There was no significant differences on factors as ethnicity,level of education,working status,marital status and living status (P＞0.05) between the baselinc and the 5-year surveys.Compared with data from the baseline survey,participants' behavior on drug abuse (100.0％ vs.24.1％,P＜0.001 ),needle sharing behavior ( 19.4％ vs.0.0％,P ＜ 0.001 ),and exchanging sex for drugs ( 34.5 ％ vs.0.0％,P＜0.001 ) had significant decreases at the 5-year survey.Rates on condom use ( 10.6％ vs.25.0％,P=0.004),and having jobs (27.8％ vs.47.7％,P＜0.001 ) had been improved significantly,while self-reported criminal cases related to drug use (15.1％ vs.1.5％,P＜0.001) and the contacts with drug users (88.9％ vs.31.3％,P＜0.001) had been significantly reduced after joining the MMT program.Conclusion MMT could play an active role in reducing the HIV-related high-risk behaviors,criminal cases associated with drug abuse as well as enhancing the family and social functions of the MMT patients.Providing high quality service to the MMT clinic and trying to keep the drug users stick to the program remain difficult.It was also important to improve the training programs for staff working at the MMT clinics.