Objective To develop a prognostic model that integrates preoperative imaging,pathological features,and tumor marker indexes for predicting metastasis in sentinel lymph nodes(SLN).Methods The preoperative examination data of 232 breast cancer patients admitted to the First Affiliated Hospital of Zhengzhou University between January 2022 and April 2023 were retrospectively analyzed.The dataset was randomly divided into a training set(174 cases)and a validation set(58 cases)at a ratio of 3∶1.Univariate and multivariate logistic regression analyses were performed to identify independent predictors influencing SLN metastasis.A nomogram was constructed,and its accuracy and clinical applicability were evaluated using receiver operating characteristic(ROC curve)analysis,calibration curve analysis,and decision curve analysis.Results The multivariate analysis revealed that palpability,CA153,calcification,and ALN blood flow signal were identified as independent risk factors for SLN metastasis(P<0.05).These four variables were integrated into a nomogram and plotted on the ROC curve.The area under the curves(AUCs)for the training set and validation set were 0.810(95%CI:0.744～0.876)and 0.737(95%CI:0.606～0.867),respectively,indicating good predictive accuracy as demonstrated by the calibration curve.Conclusion Revised sentence:"Developing a nomogram for preoperative prediction of SLN metastasis in breast cancer patients offers a non-invasive approach for clinical application and serves as a reliable tool to identify breast cancer patients who may not require SLN biopsy,thereby facilitating decisions regarding further axillary lymph node dissection(ALND)and adjuvant therapy.

OBJECTIVETo observe the regulative effects of the acupuncture on glucose and lipid metabolism disorder in the patients of metabolic syndrome.

METHODSSeventy-six patients of metabolic syndrome were rando-mized into an acupuncture plus western medicine group (37 cases) and a western medicine group (39 cases). In the western medicine group, the conventional western medication was used for 40 days. In the acupuncture plus western medicine group, the acupuncture was combined on the basis of the treatment as the western medicine group, the acupoints were Danzhong (CV 17), Zhongwan (CV 12), Tianshu (ST 25), etc. Ten treatments were as one session. There were 3 to 5 days of intervals between the sessions and totally 30 treatments were required. The body mass index (BMI), blood lipid, blood glucose, and comprehensive therapeutic effects were compared before and after treatment in the two groups.

RESULTSBefore and after treatment, the differences were all significant in BMI, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), plasma glucose of 2 hours post glucose-load (2 hPG), fasting insulin (FINS) and insulin resistance index (HOMA-IR) (all<0.05) in the acupuncture plus western medicine group, and the results after treatment were superior to those before treatment; the difference was not significant in BMI (>0.05) and those were all significant statistically in TG, TC, LDL-C, HDL-C, FBG, 2 hPG, FINS, HOMA-IR (all<0.05) in the western medicine group, and the results after treatment were superior to those before treatment. After treatment, in comparison of the two groups, the results in the acupuncture plus western medicine group were better than those in the western medicine group. The differences were all signif-icant sta-tistically in BMI, TG, TC, LDL-C, HDL-C, FBG, 2 hPG, FINS, HOMA-IR (all<0.05).

CONCLUSIONSOn the basis of the conventional western medicine, the acupuncture relieves apparently the clinical symptoms and rectifies glucose and lipid metabolism disorder in the patients of metabolic syndrome.

Objective To investigate the anatomical changes and dose distribution deviations of locally advanced nasopharyngeal carcinoma ( NPC ) patients during intensity-modulated radiation therapy ( IMRT) . Methods Weekly cone beam CT ( CBCT) was applied to investigate the anatomical changes of enrolled 18 patients with locally advanced NPC. Dosimetric deviations were investigated with new IMRT plans after 20 fractions. Results The volumes of gross tumor volume ( GTVnx ) and GTVnd were decreased by 3. 15% and 5. 67% weekly, and decreased by a total of 22. 03% and 39. 68%, respectiely. The volumes of left and right parotids were decreased by 4. 93% and 5. 26% weekly, and decreased by a total of 29. 60% and 31. 56%, respectively. The volumes of GTVnd and parotids showed significant retraction in the first four weeks of radiation, then the retraction slowed down. The D95 of PGTVnd in Plan 2 decreased by 2. 20% (t=2. 382, P <0. 05) compared that in the initial Plan 1, while there was no significant difference on the D95 of PGTVnx , PTV1 and PTV2 . The Dmean , D50 and V30 of the left and right parotids in Plan 2 increased by 7. 34%, 12. 68%, 10. 90% (t = -3. 376, -3. 738, -3. 679,P<0. 05), and 6. 13%, 11. 17%, 9. 72% (t= -2. 550, -2. 446, -2. 673, P<0. 05), respectively, compared with Plan 1. The Dmean of larynx increased by 8. 69% in Plan 2 compared with Plan 1 ( t = -3. 099, P <0. 05). The D95 of PGTVnd in Plan(1+2) increased by 1. 37% (t= -3. 555, P<0. 05) compared with Plan 2. The Dmean, D50 and V30 of the left and right parotids in Plan(1+2) were decreased by 2. 90%, 2. 73%, 4. 62% (t=3. 089, 2. 718,2. 705, P < 0. 05), and decreased by 3. 49%, 3. 44%, 3. 80%(t=2. 781, 2. 958,4. 275, P<0. 05), respectively, compared with Plan 1. The Dmean of larynx decreased by 3. 29% (t=2. 747, P<0. 05) in Plan(1+2) compared with Plan 1. Conclusions The volumes of GTV and parotids of locally advanced NPC patients showed significant shrinks during IMRT. Replanning is necessary during the middle of IMRT to improve the target coverage and to spare the organ at risks ( OARs) .

Objective To establish a stable lung cancer A549 cell line transfected by AMP-activated protein kinase (AMPK) expression vector,and to observe the effect of AMPK on proliferation as well as on the invasive ability of A549 cells.Methods Full-length of AMPK gene was amplified and its target gene was digested,then inserted into the GV358 plasmid.Co-tranfected 293T cells were subjected to the lentivirus equipment package.Subsequently,we collected the lentivirus supernatant to infect the A549 cells and establish a stably,overexpressed cell line A549.The mRNA and protein of AMPK were examined by real-time quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and Western blotting.The proliferation and invasion abilities of A549 cells were detected by methyl thiazolyl thiazolium (MTT) and Transwell assay.Results GV358-AMPK lentivirus vectors was successfully constructed by restrictive enzyme digestion and plasmid sequencing.There were significantly increased expressions of AMPK protein (5.87 times,P =0.002) and mRNA (16.12 times,P ＜ 0.001) after transfected with GV358-AMPK compared with the Vector group.Meanwhile,AMPK overexpression showed significantly lower proliferation (the forth day:0.53 ± 0.03 vs.0.64 ±0.05,P=0.021;the fifth day:0.58 ± 0.04 vs.0.80 ± 0.07,P =0.002) and weaken invasive ability [(1.6±0.5) ×l05 vs.(3.4±0.3) ×105,P=0.004] ofA549 cells.Conclusion The lentiviralAMPK expression vector and its A549 cell line is successfully constructed.AMPK overexpression inhibits the proliferation and invasive ability of A549 cells.

OBJECTIVE: To investigate the rare earth elements(REEs) contents and distribution characteristics in nasopharyngeal carcinoma( NPC) tissue in Gannan region. METHOD: Thirty patients of NPC in Gannan region were included in this study. The REEs contents were measured by tandem mass spectrometer inductively coupled plasma(ICP-MS/MS) in 30 patients, and the REEs contents and distribution were analyzed. RESULT: The average standard deviation value of REEs in lung cancer and normal lung tissues was the minimum mostly. Light REEs content was higher than the medium REEs, and medium REEs content was higher than the heavy REEs content. REEs contents changes in nasopharyngeal carcinoma were variable obviously, the absolute value of Nd, Ce, Pr, Gd and other light rare earth elements were variable widely. The degree of changes on Yb, Tb, Ho and other heavy rare earth elements were variable widely, and there was presence of Eu, Ce negative anomaly(δEu=0. 385 5, δCe= 0. 523 4). CONCLUSION The distribution characteristic of REEs contents in NPC patients is consistent with the parity distribution. With increasing atomic sequence, the content is decline wavy. Their distribution patterns were a lack of heavy REEs and enrichment of light REEs, and there was Eu , Ce negative anomaly.
Carcinoma ; Humans ; Lung ; Lung Neoplasms ; Metals, Rare Earth ; chemistry ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; chemistry ; Reference Values ; Tandem Mass Spectrometry

Objective To develop a method to determine Pb and Cd in Qingkailing Injection by graphite furnace atomic absorption spectrometry, and search their source. Methods The samples, digested via microwave, were determined the contents of Pb and Cd by graphite furnace atomic absorption spectrometry in raw material, intermediate and finished product of Qingkailing Injection. Results The standard curve of Pb was Y=0.007 3X+0.011 6, and Cd was Y=0.056 7X+0.060 4. The regression equation of Pb and Cd was 97.0% and 95.6%, respectively. Content determination of Pb and Cd in Qingkailing Injection revealed that Pb and Cd in finished product came from raw materials. Conclusion The method is rapid, high sensitive and accurate, and can be applied to the inspection of Pb and Cd in Qingkailing Injection.

Objective:A study was conducted to determine the expression of acetyl-coa carboxylase product of phosphorylation (P-ACC) and an enzyme called cyclooxygenase 2 (COX-2) in non-small cell lung cancer (NSCLC) tissue, as well as the relationship and correlations between tumor size, lymph node metastasis, clinical stage, and pathological type. Methods: Sixty-two patients with NSCLC lung cancer tissues were included in the patient group, whereas 20 patients who underwent lobectomy for other reasons and had normal lung tissues were included in the control group. Immunohistochemical streptavidin peroxidase method was used to detect the expression of P-ACC and COX-2 in lung cancer and normal lung tissues. Results:The positive expressions of P-ACC and COX-2 in NSCLC lung cancer and normal lung tissues were significantly different (P<0.05). In NSCLC tissues, the positive expression of P-ACC was significantly associated with tumor size (P<0.05), but was not significantly associated with lymph node metastasis, clinical stage, and pathological type. We found no correlation between the positive expression of COX-2 and tumor size, lymph node metasta-sis, clinical stage and pathological type. Further analysis revealed that the positive expression of P-ACC and COX-2 in NSCLC was sig-nificantly and negatively correlated (r=-2.37, P=0.032). Conclusion:The positive expression of COX-2 in NSCLC greatly increased compared with that of P-ACC, and a significantly negative correlation was observed between them. We propose that the positive expres-sion of P-ACC reduction may activate the positive expression of COX-2 and promote the occurrence, development, invasion, and metas-tasis of NSCLC.

OBJECTIVETo detect serum content of cofilin protein in patients with lung cancer and investigate its clinical value.

METHODSThe serum content of cofilin protein was detected in 30 cases of lung cancer and 30 healthy control subjects using enzyme-linked immunosorbent assay.

RESULTSThe mean serum content of cofilin protein was 0.485∓0.465 ng/ml in patients with lung cancer and 0.203∓0.102 ng/ml in the control subjects, showing a significant difference between them (P<0.05). The content of cofilin protein in patients with stage III and IV lung cancer 0.744∓0.584 ng/ml, significantly higher than that in stage II patients (0.257∓0.126 ng/ml).

CONCLUSIONSerum cofilin protein is elevated in patients with lung cancer, especially in cases in advanced stages, suggesting its relation with lung cancer staging.

Actin Depolymerizing Factors ; blood ; Adenocarcinoma ; blood ; diagnosis ; pathology ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; blood ; diagnosis ; pathology ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Lung Neoplasms ; blood ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging

OBJECTIVE: To raise clinical awareness of carcinoembryonic antigen(CEA) increased as initial manifestation of medullary thyroid cancer(MTC) and explore the diagnosis and treatment. METHOD: Clinical data of 2 cases CEA increased as the initial presentation of MTC were retrospectively analyzed and clinical manifestations of the disease, diagnosis, treatment were also discussed by literature reviewing. RESULT: Two patients received thyroid ipsilateral lobe total resection, MTC was confirmed by intraoperative frozen pathology, re-total resection of the contralateral lobe and bilateral VI lymph node dissection were performed. Lymph nodes had no metastasis confirmed by pathological frozen examination. CEA returned to normal within 2 months after surgery. No tumor recurrence and metastasis were found after follow-up for 3 to 24 months. CONCLUSION CEA increased as the initial presentation MTC was rare and clinical identification of CEA increased disease should be taken into account the MTC as possible. Total thyroidectomy and bilateral VI lymph node dissection was the main surgical treatment for it.
Adult ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Neuroendocrine ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms ; metabolism ; pathology

Objective To detect serum content of cofilin protein in patients with lung cancer and investigate its clinical value. Methods The serum content of cofilin protein was detected in 30 cases of lung cancer and 30 healthy control subjects using enzyme-linked immunosorbent assay. Results The mean serum content of cofilin protein was 0.485 ± 0.465 ng/ml in patients with lung cancer and 0.203 ± 0.102 ng/ml in the control subjects, showing a significant difference between them (P<0.05). The content of cofilin protein in patients with stage III and IV lung cancer 0.744±0.584 ng/ml, significantly higher than that in stage II patients (0.257±0.126 ng/ml). Conclusion Serum cofilin protein is elevated in patients with lung cancer, especially in cases in advanced stages, suggesting its relation with lung cancer staging.