Purpose: Breast cancer (BC) is a predominant malignancy globally, surpassing lung cancer in terms of diagnostic frequency, with an escalating incidence rate in recent decades.Recent studies have investigated the role of protein kinase C zeta (PRKCZ) in diverse cellular processes in cancer biology. In this study, we evaluated the association between PRKCZ and deleterious outcomes in BC and elucidated the mechanisms underlying its expression in breast carcinoma. Methods: The correlation between PRKCZ and survival rates of patients with BC was investigated using The Cancer Genome Atlas database. The methylation status of the PRKCZ promoter was analyzed using the UALCAN database. Furthermore, we investigated the mechanisms underlying PRKCZ inactivation in BC by treatment with transferase inhibitors, methylation-specific polymerase chain reaction (PCR) analysis, western blotting, and luciferase reporter gene assays. The degree of methylation and expression levels of PRKCZ, as regulated by DNA methyltransferase 1 (DNMT1), were quantified using quantitative PCR and western blotting. Results: Our analysis revealed that decreased expression of PRKCZ in BC was significantly correlated with poor clinical prognosis. Furthermore, we observed that hypermethylation of the PRKCZ promoter contributed to its reduced expression in BC. Notably, DNMT1 has been identified as a critical regulator of PRKCZ methylation. Conclusion Our findings elucidate the tumor-suppressive function of PRKCZ and provide insights into the molecular mechanisms underlying its downregulation in BC.

Purpose: Breast cancer (BC) is a predominant malignancy globally, surpassing lung cancer in terms of diagnostic frequency, with an escalating incidence rate in recent decades.Recent studies have investigated the role of protein kinase C zeta (PRKCZ) in diverse cellular processes in cancer biology. In this study, we evaluated the association between PRKCZ and deleterious outcomes in BC and elucidated the mechanisms underlying its expression in breast carcinoma. Methods: The correlation between PRKCZ and survival rates of patients with BC was investigated using The Cancer Genome Atlas database. The methylation status of the PRKCZ promoter was analyzed using the UALCAN database. Furthermore, we investigated the mechanisms underlying PRKCZ inactivation in BC by treatment with transferase inhibitors, methylation-specific polymerase chain reaction (PCR) analysis, western blotting, and luciferase reporter gene assays. The degree of methylation and expression levels of PRKCZ, as regulated by DNA methyltransferase 1 (DNMT1), were quantified using quantitative PCR and western blotting. Results: Our analysis revealed that decreased expression of PRKCZ in BC was significantly correlated with poor clinical prognosis. Furthermore, we observed that hypermethylation of the PRKCZ promoter contributed to its reduced expression in BC. Notably, DNMT1 has been identified as a critical regulator of PRKCZ methylation. Conclusion Our findings elucidate the tumor-suppressive function of PRKCZ and provide insights into the molecular mechanisms underlying its downregulation in BC.

Purpose: Breast cancer (BC) is a predominant malignancy globally, surpassing lung cancer in terms of diagnostic frequency, with an escalating incidence rate in recent decades.Recent studies have investigated the role of protein kinase C zeta (PRKCZ) in diverse cellular processes in cancer biology. In this study, we evaluated the association between PRKCZ and deleterious outcomes in BC and elucidated the mechanisms underlying its expression in breast carcinoma. Methods: The correlation between PRKCZ and survival rates of patients with BC was investigated using The Cancer Genome Atlas database. The methylation status of the PRKCZ promoter was analyzed using the UALCAN database. Furthermore, we investigated the mechanisms underlying PRKCZ inactivation in BC by treatment with transferase inhibitors, methylation-specific polymerase chain reaction (PCR) analysis, western blotting, and luciferase reporter gene assays. The degree of methylation and expression levels of PRKCZ, as regulated by DNA methyltransferase 1 (DNMT1), were quantified using quantitative PCR and western blotting. Results: Our analysis revealed that decreased expression of PRKCZ in BC was significantly correlated with poor clinical prognosis. Furthermore, we observed that hypermethylation of the PRKCZ promoter contributed to its reduced expression in BC. Notably, DNMT1 has been identified as a critical regulator of PRKCZ methylation. Conclusion Our findings elucidate the tumor-suppressive function of PRKCZ and provide insights into the molecular mechanisms underlying its downregulation in BC.

Hepatocellular carcinoma (HCC) poses a significant hazard to public health in China because of its high incidence, high mortality, and high rate of advanced stages. Early detection and treatment of HCC by screening for high-risk populations is instrumental for enhancing survival rates among patients with HCC in China. Liver resection, local ablation, interventional therapy, radiotherapy, and drug therapy are all effective treatments for patients with HCC, and appropriate treatments can be selected based on different tumor stages. However, the condition of patients with HCC in China is complicated, and no single specialty offers the complete spectrum of care. The disease-centered multidisciplinary team for HCC is a crucial method to prolong the survival of patients with HCC and optimize their quality of life. Recent advancements in different disciplines have brought new opportunities in HCC treatments and altered multidisciplinary management approaches. Meanwhile, new challenges have emerged, and many problems have yet to be addressed.

INTRODUCTION: Post-anaesthesia care unit (PACU) delirium affects 5%-45% of patients after surgery and is associated with postoperative delirium and increased mortality. Up to 40% of PACU delirium is preventable, but it remains under-recognised due to a lack of awareness of its diagnosis. The nursing delirium screening scale (Nu-DESC) has been validated for diagnosing PACU delirium, but is not routinely used locally. This study aimed to use Nu-DESC to establish the incidence and risk factors of PACU delirium in patients undergoing non-cardiac surgery in the surgical population. METHODS: We conducted an audit of eligible patients undergoing major surgery in three public hospitals in Singapore over 1 week. Patients were assessed for delirium 30-60 min following their arrival in PACU using Nu-DESC, with a total score of ≥2 indicative of delirium. RESULTS: A total of 478 patients were assessed. The overall incidence rate of PACU delirium was 18/478 (3.8%), and the incidence was 9/146 (6.2%) in patients aged > 65 years. Post-anaesthesia care unit delirium was more common in females, patients with malignancy and those who underwent longer operations. Logistic regression analysis showed that the use of bispectral index (P < 0.001) and the presence of malignancy (P < 0.001) were significantly associated with a higher incidence of PACU delirium. CONCLUSION In this first local study, the incidence of PACU delirium was 3.8%, increasing to 6.2% in those aged > 65 years. Understanding these risk factors will form the basis for which protocols can be established to optimise resource management and prevent long-term morbidities and mortality in PACU delirium.
Female ; Humans ; Delirium/epidemiology* ; Postoperative Complications/etiology* ; Singapore/epidemiology* ; Prospective Studies ; Anesthesia/adverse effects* ; Risk Factors ; Neoplasms

INTRODUCTION: Post-anaesthesia care unit (PACU) delirium is a potentially preventable condition that results in a significant long-term effect. In a multicentre prospective cohort study, we investigate the incidence and risk factors of postoperative delirium in elderly patients undergoing major non-cardiac surgery. METHODS: Patients were consented and recruited from 4 major hospitals in Singapore. Research ethics approval was obtained. Patients older than 65 years undergoing non-cardiac surgery >2 hours were recruited. Baseline perioperative data were collected. Preoperative baseline cognition was obtained. Patients were assessed in the post-anaesthesia care unit for delirium 30-60 minutes after arrival using the Nursing Delirium Screening Scale (Nu-DESC). RESULTS Ninety-eight patients completed the study. Eleven patients (11.2%) had postoperative delirium. Patients who had PACU delirium were older (74.6±3.2 versus 70.6±4.4 years, P=0.005). Univariate analysis showed those who had PACU delirium are more likely to be ASA 3 (63.6% vs 31.0%, P=0.019), had estimated glomerular filtration rate (eGFR) of >60mL/min/1.73m2 (36.4% vs 10.6%, P=0.013), higher HbA1C value (7.8±1.2 vs 6.6±0.9, P=0.011), raised random blood glucose (10.0±5.0mmol/L vs 6.5±2.4mmol/L, P=0.0066), and moderate-severe depression (18.2% vs 1.1%, P=0.033). They are more likely to stay longer in hospital (median 8 days [range 4-18] vs 4 days [range 2-8], P=0.049). Raised random blood glucose is independently associated with increased PACU delirium on multivariate analysis.
Aged ; Anesthesia ; Anesthesia Recovery Period ; Delirium/etiology* ; Humans ; Incidence ; Postoperative Complications/etiology* ; Prospective Studies ; Risk Factors

INTRODUCTION: Airway management outside the operating room can be challenging, with an increased risk of difficult intubation, failed intubation and complications. We aim to examine airway practices, incidence of difficult airway and complications associated with airway code (AC) activation. METHODS: We conducted a prospective audit of AC activations and adverse events in two tertiary hospitals in Singapore. We included all adult patients outside the operating room who underwent emergency intubation by the AC team after AC activation. Adult patients who underwent emergency intubation without AC activation or before the arrival of the AC team were excluded. Data were collected and documented by the attending anaesthetists in a standardised survey form shortly after their responsibilities were completed. RESULTS: The audit was conducted over a 20-month period from July 2016 to March 2018, during which a total of 224 airway activations occurred. Intubation was successful in 218 of 224 AC activations, giving a success rate of 97.3%. Overall, 48 patients (21.4%) suffered an adverse event. Thirteen patients (5.8%) had complications when intubation was carried out by the AC team compared with 35 (21.5%) by the non-AC team. CONCLUSION Dedicated AC team offers better success rate for emergency tracheal intubation. Non-AC team attempted intubation in the majority of the cases before the arrival of the AC team. Increased intubation attempts are associated with increased incidence of adverse events. Equipment and patient factors also contributed to the adverse events. A multidisciplinary programme including the use of supraglottic devices may be helpful to improve the rate of success and minimise complications.

Hepatocellular carcinoma (HCC) accounts for approximately 75%-85% of primary liver cancer cases and is one of the most frequently diagnosed malignancies worldwide. Immunotherapy is currently considered to be the most promising treatment to prevent the progression and postoperative recurrence of HCC. At present, the treatment strategies of immunotherapy for HCC are classified as active immunotherapy and passive immunotherapy, including tumor vaccine therapy, immune checkpoint inhibitors, and adoptive cell therapy. Here we review the current clinical progression and discuss the future perspective on immune therapy for HCC.

Objective To investigate status of internet addiction and circadian typology in college students and to explore the relationship between circadian typology and internet addiction. Methods A total of 3 572 college students including freshmen and juniors was enrolled in the study. Circadian typology and internet addiction were assessed by morningness-eveningness questionnaire(MEQ) and internet addiction test (IAT) respectively. All questionnaires were self-reported. Results The score of IAT was (38. 46±11. 84) points and incidence of internet addiction was 41. 7%. Freshmen and juniors were significantly different in distribution of circadian typology and IAT scores(χ2=10. 51,P<0. 05; t=5. 90,P<0. 01). Proportion of the evening type and scores of IAT of juniors(33. 0%,(39. 66±12. 71)points) were both higher than those of freshmen(28. 3%,(37. 32±10. 82)points). For freshmen,IAT scores of evening type students((40. 79± 11. 33)points) was higher than those of intermediate type students((36. 54±10. 27)points) and morning type students((32. 27±9. 66)points),and the differences were statistically significant(F=51. 81,P<0. 01). For juniors,IAT scores of evening type students((42. 90±13. 02)points) was higher than those of intermedi-ate type students((38. 61±12. 19)points) and morning type students((34. 06±11. 92)points),and the differences were statistically significant(F=37. 80,P<0. 01). After adjusting for gender,age,grade and par-ents’ educational level by analysis of covariance,IAT scores were still statistically different in circadian ty-pology(F=93. 53,P<0. 01). Results from ordinal logistic regression showed that grade(juniors compared to freshman,OR=1. 42,P<0. 01) and circadian typology (evening type compared to morning type,OR=3. 82,P<0. 01; intermediate type compared to morning type,OR=1. 97,P<0. 01) were independent factors influen- cing internet addiction. Conclusion Internet addiction of college students is at a high level and different in grades. Compared with junior students,senior students are at a higher level of internet addiction. College students with evening type are more likely to be internet addicted.

Objective To explore the gastric tube indwelling with different length, in order to find out the best length for stroke patients. Methods A total of 182 stroke patients with enteral nutrition by nasogastric tube were randomly assigned into control group (n=58), observation group A (n=60) and observation group B(n=64). The indwelling length of nasogastric tube was from eyebrows to earlap then mucronate cartilage in the control group (45-55 cm); based on this length, additional 15 cm was extended in observation group A (60-70 cm);the length for observation group B was 55-65 cm from eyebrows to navel. The situation of gastric tube inserting, the incidence of regurgitation, bucking and aspiration and the residual gastric volume in three groups were compared. Results A total of 53 cases (91. 38%) of the control group had gastric tube ends at the cardia;in the observation group, 44 cases (73. 33%) of group A had gastric tube ended at the pylorus, and 55 cases (85. 94%) of observation group B in the body of the stomach. The incidence of regurgitation, bucking and aspiration in observation group A and group B were both significant lower than those of the control group (P<0.01), but the residual gastric volumes in two groups were more than that of the control group (P <0. 01);there were no significant differences between group A and group B in residual gastric volume and the incidence of regurgitation, bucking and aspiration (P >0. 05). However, there were 8 cases (13. 33%) of gastric tube twisting or knotting in stomach in group A, and 2 cases ( 3. 33%) of gastric tube entering the duodenum. Conclusions Indwelling gastric tube with the length of 55 -65 cm ( from eyebrow to navel) is simple and reasonable for stroke patients in patients with different height, so it is worthy of promotion in clinical practice.