BACKGROUND: To date, results on relationship between CYP3A4 gene polymorphism were limited and inconclusive, and no study focused on the influence of CYP3A4 gene-obesity interaction on breast cancer risk, especially in Chinese women. The purpose of this study was to evaluate the impact of four single nucleotide polymorphisms (SNPs) of CYP3A4 gene, the SNP-SNP and gene-environment interactions on the susceptibility to breast cancer in Chinese women. METHODS: Logistic regression was used to explore the relationship between four SNPs of CYP3A4 gene and the risk of breast cancer. Generalized multifactor dimensionality reduction (GMDR) was used to screen the best SNP-SNP and gene-abdominal obesity interaction combinations among four SNPs and abdominal obesity. Haplotype examination among 4 SNPs was conducted using the SHEsis web-based platform. RESULTS: Logistic regression analysis showed that carriers of rs2242480- T allele have significantly higher breast cancer risk, than those with rs2242480- CC genotype, adjusted OR (95%CI) was 1.68 (1.23-2.16) and 2.03 (1.53-2.58) for participants with CT genotype and TT genotype under additive model. We did not find any notable interactions between the four SNPs within the CYP3A4 gene. GMDR model found a significant association in a two-locus model involving rs2242480 and obesity, with a p-value of 0.018. Stratified analysis found that breast cancer risk was the highest in obese participants with rs2242480- CT or TT genotype, compared to those non-obese participants with rs2242480- CC genotype, OR (95%CI) was 3.02 (1.83-4.25). We found that all haplotype combinations were not correlated with breast cancer risk. CONCLUSIONS We found that the T allele of rs2242480 within the CYP3A4 gene and interaction between rs2242480 and obesity were associated with an increased risk of breast cancer. However, the results of this study were only applicable to the Han ethnic group and cannot be generalized to other ethnic groups in China, and more SNPs of CYP3A4 gene should been enrolled in the analysis in the future, to verify the results obtained in this study.
Adult ; Aged ; Female ; Humans ; Middle Aged ; Breast Neoplasms/etiology* ; China/epidemiology* ; Cytochrome P-450 CYP3A/metabolism* ; Gene-Environment Interaction ; Genetic Predisposition to Disease ; Haplotypes ; Obesity/epidemiology* ; Polymorphism, Single Nucleotide ; Risk Factors ; East Asian People

Objective    To evaluate the learning curve of CT-guided medical glue localization for pulmonary nodule before video-assisted thoracic surgery (VATS). Methods    The clinical data of the patients with pulmonary nodules who underwent CT-guided medical glue localization before VATS in our hospital from July 2018 to March 2021 were retrospectively analyzed. The patients were divided into 3 groups: a group A (from July 2018 to August 2019), a group B (from September 2019 to June 2020) and a group C (from July 2020 to March 2021). The localization time, morbidity, complete resection rate and other indexes were compared among the three groups. Results    A total of 77 patients were enrolled, including 24 males and 53 females aged 57.4±10.1 years. There were 25 patients in the group A, 21 patients in the group B, and 31 patients in the group C. 77 pulmonary nodules were localized. There was no significant difference among the groups in the basic data (P>0.05). The localization time in the group C was 10.6±2.0 min, which was statistically shorter than that in the group A (15.4±4.4 min) and group B (12.9±4.3 min) (P<0.01). The incidence of complications in the group C was lower than that in the group A and group B (25.8% vs. 52.0% vs. 47.6%, P=0.04). The success rate of localization of the three groups was not statistically different (P=0.12). Conclusion    There is a learning curve in CT-guided medical glue localization for single pulmonary nodule before VATS. After the first 46 cases, the operation time can be shortened, and the incidence of complications can be decreased.

Objective: To explore the relationship between isochronous substitution and BMI, waist circumference (WC), and body fat rate (FAT) among physical activity (PA), sedentary (SB), and sleep (SLP), so as to provide effective measures for obesity control in adolescents. Methods: A total of 193 adolescents aged 12-15 (90 males and 103 females) was randomly selected, and their height, weight, and BMI were measured using routine testing methods from May to August 2022. The PA, SB and SLP of the participants were measured using a 3D accelerometer (ActiGraph GT3X+). Results: The arithmetic mean value overestimated SLP (40.8%) and SB (39.6%) to some extent, and underestimated LPA (16.1%) and MVPA (3.5%) to some extent. Based on the ISM at 15 min, MVPA was substituted for other activity, BMI Z decreased by 0.17-0.22 units, WC Z decreased by 0.16-0.20 units, and FAT Z decreased by 0.17-0.22 units. The substitution between MVPA and for other activity exhibited significant asymmetry. The effects of MVPA substitutions for SB was the largest, followed by the effects of MVPA substitutions for SLP, and the effects of MVPA substitutions for LPA was the lowest. As MVPA substitutions for other behaviors, it reached its maximum (0.06-0.08 units ) when the MVPA time increased by 5 minutes. Conclusions MVPA plays an irreplaceable role in the control of adolescent obesity . While reducing SB time, MVPA duration should be increased to ensure that the daily MVPA duration is not less than 55 minutes in order to effectively control obesity.

BACKGROUND: The localization of pulmonary nodules is related to whether the lesions can be found and removed accurately and quickly. It is an important link for the success of minimally invasive video-assisted thoracic surgery (VATS). This study investigated the feasibility of medical glue localization under VATS video-assisted thoracoscopic computed tomography (CT) guidance for single pulmonary nodule and more than two pulmonary nodules, and compared with the accuracy and safety of single nodule localization. METHODS: A retrospective analysis of the clinical data of patients who underwent unilateral CT-guided medical glue localization before VATS from November 2018 to March 2021 were performed, the patients was divided into multiple pulmonary nodules group (localized nodules ≥2) and single pulmonary nodule group according to the number of localized nodules. The localization time, success rate and complication rate of the two groups were compared. RESULTS: There were 126 nodules in the two groups, including 62 in single pulmonary nodule group and 64 in multiple pulmonary nodules group. The average single nodule localization time was (13.23±4.5) min in single pulmonary nodule group and (10.52±2.8) min in multiple pulmonary nodules group, the difference between the two groups is statistically significant (P<0.05). The localization success rate of single pulmonary nodule group and multiple pulmonary nodules group were 100% and 98.4% separately, the difference between the two groups was not statistically significant (P>0.05). All VATS were successfully completed after localization. The incidence of pneumothorax was higher in multiple pulmonary nodules group than in single pulmonary nodule group (P=0.07). CONCLUSIONS Compared with localization of single lung nodule, unilateral CT-guided medical glue localization for multiple pulmonary nodules before VATS is also feasible and accuracy, it is worthy of clinical application. But the higher rate of pneumothorax should be paid attention to.
Humans ; Lung Neoplasms/surgery* ; Multiple Pulmonary Nodules/surgery* ; Pneumothorax ; Retrospective Studies ; Solitary Pulmonary Nodule/surgery* ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed

BACKGROUND: With the wide application of computed tomography (CT) in the screening of early lung cancer, more and more ground glass nodules (GGNs) have been found. Early intervention is helpful to improve the survival rate of lung cancer patients. Radiofrequency ablation (RFA) is an alternative option to manage primary or metastatic lung malignancies. The purpose of this study is to review the safety and clinical efficacy for lung GGN treated by RFA. METHODS: From June 2016 to March 2021, 24 patients with a total of 28 lung GGNs in our hospital underwent 28 sessions of RFA. There were 13 males and 11 females with an average age of (69.4±11.1) years. The size of GGN receiving RFA was (1.30±0.56) cm; The ablation range was (2.50±0.63) cm and ablation time was (15.00±8.68) min. RESULTS: The procedure of all RFAs went smoothly, no perioperative deaths occurred and no serious complications during the operation. The median follow-up was 25 months. One case died of myocardial infarction 2 months after operation. All 28 GGNs showed no evidence of local progression and the local control rate was 100.0%. Kaplan-Meier analysis showed that the 1-year and 2-year overall survival rates were 95.8% and 95.8%; the tumor specific survival rates were 100.0% and 100.0%, respectively. CONCLUSIONS RFA is a safe, effective and minimally invasive technique for the treatment of lung GGNs.
Aged ; Aged, 80 and over ; Female ; Humans ; Lung ; Lung Neoplasms/surgery* ; Male ; Middle Aged ; Radiofrequency Ablation/adverse effects* ; Tomography, X-Ray Computed

Objective:To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology.Methods:This was a retrospectively study. Newborn screening data ( n=5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data ( n=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns ' screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. Results:A total of 3 665 697 newborns ' screening data were collected including 3 019 cases ' positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment ( n=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. Conclusion:An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.

BACKGROUND: As a new technique developed in recent years, endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has the advantages of simple operation, minimal invasive, high accuracy, safety and repeatability. It has become a new standard for lung cancer diagnosis and mediastinal staging. Because small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) have different biological characteristics and treatment methods, it is very important to diagnose and differentiate the types of lung cancer in the early stage of lung cancer for the staging, treatment and prognosis of lung cancer. This article evaluated the accuracy and sensitivity of EBUS-TBNA in the diagnosis of SCLC and NSCLC. METHODS: From January 2012 to December 2018, the clinical data of 85 patients with SCLC and NSCLC who performed EBUS-TBNA in Xuan Wu Hospital CMU were retrospectively analyzed and the differences between the two groups were compared. RESULTS: 45 cases of SCLC were confirmed by immunohistochemistry and pathology. 42 cases of SCLC were diagnosed by EBUS-TBNA. The accuracy and sensitivity of diagnosis were 93.3% (42/45) and 100.0% (42/42), respectively. The positive rate of diagnosis was 48.9% (22/45) in 22 cases diagnosed by cytology, and 40 cases diagnosed by pathology, including 35 cases diagnosed by EBUS-TBNA. The accuracy and sensitivity of diagnosis were 87.5% (35/40) and 100.0% (35/35), respectively. The positive rate of diagnosis was 27.5% (11/40) in 11 cases diagnosed by cytology. The diagnostic sensitivity of EBUS-TBNA in SCLC group was significantly higher than that in NSCLC group (P<0.05). CONCLUSIONS EBUS-TBNA is more sensitive in the diagnosis of SCLC than NSCLC. As a minimally invasive technique, EBUS-TBNA can assist SCLC in early diagnosis and timely treatment.

Objective To study the diagnostic values of salivary and plasma microRNA‐21 for e early esophageal cancer . Methods Totally 112 patients with early esophageal cancer in Nanyang Municipal Central Hospital from February 2011 to Febru‐ary 2014 were selected as the observation group and contemporaneous 100 healthy people of physical examination were selected as the contract group .The salivary and plasma microRNA‐21 expression levels were compared between the two groups ;the diagnostic values of salivary versus plasma microRNA‐21 for the early esophageal cancer were also compared;the correlation between the miR‐NA‐21 level with the stage ,pathogenic type and differentiation of early esophageal cancer .Results The salivary microRNA‐21 level (6 .08 ± 2 .22) in the observation group and (0 .64 ± 0 .09) in the control group ,the difference had statistical significance (P<0 .05);the plasma microRNA‐21 level in the observation group was (20 .91 ± 10 .59) and (1 .69 ± 0 .17) in the constract group ,the difference had statistical significance (P<0 .05) .The area underROC curve(AUC) of salivary microRNA‐21 level was 0 .866 5 ,the sensitivity was 88 .24% ,the specificity was 69 .97% ;while AUC of plasma microRNA‐21 level was 0 .882 0 ,the sensitivity was 90 .20% ,the specificity was 70 .69% ,the differences in the diagnostic value had no statistical significance between them(P>0 .05) . The salivary and plasma microRNA‐21 levels had no obvious correlation with the stage and pathogenic type of early esophageal cancer(P>0 .05) ,while had strong correlation with the differentiation degree(P<0 .05) .Conclusion Salivary and plasma microR‐NA‐21 has higher diagnostic value in for early esophageal cancer ,and saliva may supplant plasma in the diagnosis of early esophage‐al cancer .

Objective To explore influence factors of gerontal patients with lung squamous carcinoma after surgical therapy . Methods 210 gerontal patients with lung squamous carcinoma were accepted surgical therapy and adjuvant therapy ,and were fol-lowed up .The survival rates of 1 ,3 and 5 years after the surgery were evaluated by Kaplan-Meier ,and influence factors were ana-lyzed by Cox regression .Results The 1 ,3 and 5 years survival rates were 89 .0% ,68 .6% and 56 .2% ,respectively .The survival rates were significantly influenced by the smoking history ,the abnormal degree of mediastinal lymph node ,TNM stage ,the class number of lymph node dissection ,and the class number of mediastinal lymph node dissection(P<0 .05) .The smoking history(χ2 =16 .198 ,P=0 .000) ,the abnormal degree of mediastinal lymph node(χ2 =8 .873 ,P=0 .003) ,TNM stage(χ2 =18 .718 ,P=0 .000) , and the class number of mediastinal lymph node dissection (χ2 =4 .897 ,P=0 .027) were the influence factors of prognostic .Conclu-sion The accurate TNM staging and mediastinal lymph node with image examination could be more appropriate to operative indica-tions ,meanwhile ,if smoking was controlled ,the class number of mediastinal lymph node dissection was more .These could be bene-ficial to the survival .

Objective To investigate the incidence of sub-health fatigue among medical workers exposing to radioactive rays, and to observe the therapeutic effect of Bushen Jianpi recipe on sub-health fatigue. Methods An investigation was carried out among 1 056 medical workers exposing to radioactive rays which were from the medical and sanitary institutions of Guangzhou city. Sixty cases subjecting to the inclusion criteria were sampled from the investigated population by epidemiological methods for the randomized controlled trial. The subjects were evenly randomized into treatment group and control group. Both groups received health education and health-promoting lifestyle, and the treatment group was given self-prescribed Bushen Jianpi recipe additionally. The treatment lasted for 4 weeks. The scores of Multidimensional Fatigue Inventory ( MFI-20) and Sub-health Measurement Scale Version 1.0 ( SHMS V1.0) were observed before and after treatment, and the therapeutic effect was evaluated after treatment. Results ( 1) We got 976 effective questionnaires, and the effective response rate was 92.4%. Among the admitted 976 workers, the incidence of sub-health state was 66.8% (652/976) and that of sub-health fatigue is 31.4% ( 205/976). ( 2) The total effective rate was 80.0% in the treatment group and was 36.7% in the control group, the difference being significant ( P<0.01). ( 3) After treatment, the scores of MFI-20 and SHMS V1.0 were decreased in the treatmeat group, and fatigue symptom scores were decreased in the control group ( P<0.05 or P<0.01) , the decrease in the treatment group being superior to that in the control group ( P<0.05 or P<0.01). Conclusion The incidence of sub-health fatigue is popular in the medical workers exposing to radioactive rays, and Bushen Jianpi recipe has an effect on improving the sub-health fatigue.