The early prediction of axillary lymph node metastasis is crucial to the treatment and prognosis of breast cancer patients. Radiomics, as a non-invasive, convenient and efficient emerging technology, can achieve deep exploration and processing of imaging images and plays an increasingly important role in the evaluation of benign and malignant breast tumors, prediction of lymph node metastasis and other aspects. This article reviews the studies on the prediction of axillary lymph node metastasis of breast cancer based on radiomics of mammography, ultrasound and magnetic resonance imaging.

Objective To predict the lymphovascular invasion(LVI)status of breast cancer patients based on digital breast tomo-synthesis(DBT)intratumoral and peritumoral radiomics nomogram.Methods A total of 192 breast cancer patients from 2 institu-tions were retrospectively selected,in which institution 1 was used for train(n=113)and test(n=49),while institution 2 was used for external validation(n=30).Radiomics features were extracted and selected based on intratumoral and peritumoral 1 mm regions from DBT images.Different machine learning algorithms were used to construct intratumoral,peritumoral,and combined intratumoral and peritumoral models,respectively.Patient clinical data were analyzed by both univariate and multivariate logistic regression analy-ses to identify independent risk factors for the clinical imaging model.The performance of the models was evaluated using the receiver operating characteristic(ROC)curve.The radiomics features with the optimal diagnostic performance and the selected clinical imaging features were combined to construct a comprehensive clinical-radiomics model,and a nomogram was drawn.Results The combined intratumoral and peritumoral model was the optimal radiomics model.Maximum tumor diameter[odds ratio(OR)=1.486,P=0.014],suspicious malignant calcifications(OR=2.898,P=0.015),and axillary lymph node(ALN)metastasis(OR=3.615,P<0.001)were independent risk factors for LVI positive.Furthermore,the area under the curve(AUC)of the comprehensive clinical-radiomics model in the training set,test set and external valida-tion set was 0.889,0.916,and 0.862,respectively,which was higher than those of the combined intratumoral and peritumoral model(0.858,0.849,0.844)and the clinical imaging model(0.743,0.759,0.732).Conclusion The predictive nomogram,derived from both radiomics and clinical imaging features,is relatively accurate in identifying future LVI occurrence in breast cancer,demonstra-ting its potential as an assistive tool for clinicians to devise individualized treatment regimes.

Objective To predict the lymphovascular invasion(LVI)status of breast cancer patients based on digital breast tomo-synthesis(DBT)intratumoral and peritumoral radiomics nomogram.Methods A total of 192 breast cancer patients from 2 institu-tions were retrospectively selected,in which institution 1 was used for train(n=113)and test(n=49),while institution 2 was used for external validation(n=30).Radiomics features were extracted and selected based on intratumoral and peritumoral 1 mm regions from DBT images.Different machine learning algorithms were used to construct intratumoral,peritumoral,and combined intratumoral and peritumoral models,respectively.Patient clinical data were analyzed by both univariate and multivariate logistic regression analy-ses to identify independent risk factors for the clinical imaging model.The performance of the models was evaluated using the receiver operating characteristic(ROC)curve.The radiomics features with the optimal diagnostic performance and the selected clinical imaging features were combined to construct a comprehensive clinical-radiomics model,and a nomogram was drawn.Results The combined intratumoral and peritumoral model was the optimal radiomics model.Maximum tumor diameter[odds ratio(OR)=1.486,P=0.014],suspicious malignant calcifications(OR=2.898,P=0.015),and axillary lymph node(ALN)metastasis(OR=3.615,P<0.001)were independent risk factors for LVI positive.Furthermore,the area under the curve(AUC)of the comprehensive clinical-radiomics model in the training set,test set and external valida-tion set was 0.889,0.916,and 0.862,respectively,which was higher than those of the combined intratumoral and peritumoral model(0.858,0.849,0.844)and the clinical imaging model(0.743,0.759,0.732).Conclusion The predictive nomogram,derived from both radiomics and clinical imaging features,is relatively accurate in identifying future LVI occurrence in breast cancer,demonstra-ting its potential as an assistive tool for clinicians to devise individualized treatment regimes.

The early prediction of axillary lymph node metastasis is crucial to the treatment and prognosis of breast cancer patients. Radiomics, as a non-invasive, convenient and efficient emerging technology, can achieve deep exploration and processing of imaging images and plays an increasingly important role in the evaluation of benign and malignant breast tumors, prediction of lymph node metastasis and other aspects. This article reviews the studies on the prediction of axillary lymph node metastasis of breast cancer based on radiomics of mammography, ultrasound and magnetic resonance imaging.

Objective To establish a finite element model of cell perfusion culture, and study the effect of different perfusion speeds on the movement of suspended cells. Methods The two-dimensional (2D) model of cell and microchannels was established using COMSOL Multiphysics and meshed. Three groups were established according to the perfusion speed, namely, u0=0.196 mm/s, u1=0.117 mm/s, u2=0.04 mm/s. The fluid-structure interaction module was used for calculation. Results The flow field distribution in the microchannel was relatively uniform. During the equal period of time, the ratio of cell suspension perfusion speed was u0∶u1∶u2=5∶3∶1, and the ratio of cell displacement in the microchannel was D0∶D1∶D2=4.1∶ 2.9∶1. When the speed was proportional, the displacement of cells also roughly followed the corresponding proportional change. With the increase of perfusion speed, stress concentration in cells during movement would occur. The stress and fluid shear force (FSS) of cells during movement were within the safe value range, and cell destruction would not occur. Conclusions The suspended cells can enter into the microchannel without injury at a certain perfusion speed. Perfusion techniques can be used in cell implantation of in vitro tissue engineering products.

At present, acellular matrix is an effective replacement material for the treatment of skin damage, but there are few systematic evaluation studies on its performance. The experimental group of this study used two decellularization methods to prepare the matrix: one was the acellular matrix which sterilized with peracetic acid first (0.2% PAA/4% ethanol solution) and then treated with hypertonic saline (group A), the other was 0.05% trypsin/EDTA decellularization after γ irradiation (group B); and the control group was soaked in PBS (Group C). Then physical properties and chemical composition of the three groups were detected. Hematoxylin eosin (HE) staining showed that the acellular effect of group B was good. The porosity of group A and B were both above 84.9%. In group A, the compressive modulus of elasticity was (9.94 ± 3.81) MPa, and the compressive modulus of elasticity was (12.59 ± 5.50) MPa in group B. There was no significant difference between group A or B and group C. The total content of collagen in acellular matrix of group A and B was significantly lower than that of group C (1. 662 ± 0.229) mg/g, but there was no significant difference in the ratio of collagen Ⅰ/Ⅲ between group B and group C. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) showed that there was no significant difference in microstructure. Qualitative detection of fibronectin and elastin in each group was basically consistent with that in group C. Therefore, acellular matrix of group B had better performance as scaffold material. The experimental results show that the acellular matrix prepared by γ-ray sterilization and decellularization of 0.05% Trypsin enzyme/EDTA could be used for the construction of tissue-engineered skin. It could also provide reference for the preparation and mounting of heterogeneous dermal acellular matrix. It was also could be used for electrostatic spinning or three-dimensional printed tissue engineered skin scaffold which could provide physical and chemical parameters for it.
Acellular Dermis ; Cells, Cultured ; Extracellular Matrix ; Porosity ; Tissue Engineering ; Tissue Scaffolds

Objective To analyze the diagnostic value of features of mammographic mass edge in digital three dimensional tomography, and to discuss the correlations between the mammographic mass edge features and pathological features and molecular biological indicators, in order to provide evidence for early and accurate diagnosis and treatment of breast cancer and prognosis evaluation. Methods A retrospective analysis was made in 392 cases of breast cancer confirmed by operation and pathology in the People ' s Hospital of Shanxi Province from August 2017 to June 2018. These patients were examined by digital breast tomography (DBT) and full-field digital mammography (FFDM) before operation. Postoperative specimens were stained by immunohistochemical SP method to measure the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki-67. The correlation between the mammographic mass edge features and pathological features and molecular biological indicators were analyzed by usingχ2 test and Fisher exact probability method. Results In 392 patients, 352 cases (89.80％) were invasive ductal carcinoma, 6 cases (1.53％) were ductal carcinoma in situ with microinvasion, 7 cases (1.79％) were invasive lobular carcinoma, 17 cases (4.34％) were papillary carcinoma, 8 cases (2.04％) were mucinous carcinoma, 1 case (0.26％) was medullary carcinoma, and 1 case (0.26％) was metaplastic carcinoma. DBT were significantly better than FFDM in the detection rate [93.6％ (367/392) vs. 77.8％ (305/392)] and the diagnostic coincidence rate [88.2％(345/392) vs. 76.8％(278/392)] for breast cancer and judging the marginal features of tumor. The DBT imaging features of mucinous carcinomas were mostly regular in shape and clear in margin. The DBT imaging features of invasive ductal carcinomas were marginal burr sign or burr with lobulation sign. Immunohistochemical detection displayed the positive expression rates of ER and PR were highest, the positive expression rates of HER2 and Ki-67 were the lowest in marginal burr masses;the positive expression rates of ER and PR were high, the positive expression rates of HER2 and Ki-67 were low in marginal lobulated masses; the positive expression rate of HER2 was highest in borderline masses or partial borderline masses; the positive expression rates of HER2 and Ki-67 were highest in clear margin masses. Conclusions Breast DBT can reduce or eliminate the tissue overlap in FFDM examination, and improve the detection rate, the diagnostic coincidence rate and the specificity of breast cancer. It can also indirectly provide evidence for preoperative judgment of biological behavior of tumors, guide clinical treatment and assess the prognosis through the morphological and marginal features of breast masses. Breast DBT is worthy of a wide clinical application in breast examination.

Objective To describe the change of symptoms and quality of life among nasopharyngeal carcinoma patients who undergo radiotherapy, and analyze the correlation between them.Methods A total of 218 nasopharyngeal carcinoma patients who received radiotherapy were included by convenient sampling method and they were asked to finish the questionnaire of general information, Chinese Version of the M.D. Anderson Symptom Inventory(MDASI-C) and Quality of Life Instruments for Cancer Patients-Head and Neck (QLICP-HN) at five time points, which were beginning, intermediate (the volume of radiotherapy at 36-40 Gy), end of radiotherapy, three months and six months after radiotherapy.Results The severity of symptoms at five time points were (1.86±1.75),(3.20±1.75),(3.59±1.81),(0.65±0.59) and (0.52±0.50), presenting decreased gradually first, and then alleviated. The score of symptom severity at five time points were significantly different (F=182.86,P<0.05). Fatigue, appetite loss and dry mouth were the most sever and high-incidence symptoms during and within six months after radiotherapy. The quality scores of life were (65.39±10.90),(58.78±8.77),(57.82±9.20),(79.76±5.75) and( 76.79±4.78) at five time points, representing the same trend as the scores of symptom, and the difference were statistically significan(t F=129.75,P< 0.05). Spearman correlation analysissuggested that there were negative correlation between severity of symptoms and total score of quality of life (P < 0.05). Conclusions The symptoms of nasopharyngeal carcinoma patients exacerbates with dose of radiotherapy increase, and the quality of life is also decreased. Although most of symptoms disappear within six months after radiotherapy, fatigue, appetite loss and dry mouth persisted and influence patients' quality of life.Nurses should pay attention to patients' symptoms when they stay at hospital as well as discharged, and intervention is necessary to improve their quality of life.

Objective To investigate the dynamic changes of symptom clusters among nasopharyngeal carcinoma patients receiving radiotherapy and provide evidence for intervention clinically.Methods The data were collected at three time points that were before radiotherapy,during the radiotherapy and after radiotherapy, by surveying 273 first visit of nasopharyngeal carcinoma patients from May 201 4 to January 201 5 with a self-designed general information questionnaire and the Chinese version of the M.D.Anderson symptom inventory and observing the changes of symptom clusters in our hospital.One-way analysis of variance and the exploratory factor analysis were applied to observe the incidence of symptoms and the changes of symptom clusters during radiotherapy.Results The statistics revealed that the incidence and intensity of all the symptoms at 3 time points were significantly increased(P <0.05),except the symptom of amnesia.There were 3 symptom clusters among 3 time points,named as gastrointestinal symptom cluster,sickness symptom cluster and somatic symptom cluster,but the composition and the variance were different at different time point.Gastrointestinal symptom cluster was made of nausea and vomiting,adding poor appetite only before radiotherapy.The gastrointestinal symptom cluster was most prominent before radiotherapy.Sickness symptom cluster consisted of drowsiness, numbness symptom before radiotherapy, while it consisted of shortness of breath, numbness, difficulty remembering symptoms in other time.Somatic symptom cluster mainly consisted of pain and fatigue,dry mouth symptom joining it during and after radiotherapy.Conclusions With the treatment of radiotherapy,the incidence and intensity of symptoms are significantly enhanced,and the constitution of symptom clusters is different at different stage.Therefore,it is important for clinical nurses to strengthen dynamic assessment of all symptoms,monitor the changes and composition of symptom clusters,thus establish corresponding management measures to improve patients′quality of life.

Bartter′s syndrome(BS) is a rare renal tubular diseases and an autosomal recessive hereditary disease. The characteristic findings are hypokalemia, metabolic alkalosis, and raised serum renin and aldosterone levels. Combination of metabolic syndrome with Bartter′s syndrome has not been reported so far. Here in, we report a case in order to call attention to the diagnosis and treatment of typical Bartter′s syndrome combined with metabolic syndrome.