Objective To investigate the expression characteristics of RAB1A in the breast tumor microenvironment (TME) and its mechanism of promoting tumor metastasis, with the aim of identifying potential targets for TME-targeted antimetastatic therapy. Methods Proteomic sequencing was performed on tumor and adjacent tissues from 16 patients with triple-negative breast cancer (TNBC) or HER2-overexpressing breast cancer. Single-cell RNA sequencing was conducted on biopsy samples from four patients with TNBC or HER2-overexpressing breast cancer. TME cell heterogeneity and RAB1A expression patterns were analyzed at the proteomic and single-cell transcriptomic levels. ELISA and wound healing assays were utilized to verify the mechanism by which RAB1A regulates the function of cancer-associated fibroblasts (CAFs), thereby promoting the metastasis of TNBC cells. Results RAB1A was specifically highly expressed in CAFs. Functional module analysis indicated an association with the prometastatic secretion pathway and matrix remodeling modules. Human mammary fibroblasts (HMFs), CAFs, and RAB1A-overexpressing CAFs (CAF-OE-RAB1A) were cocultured with MDA-MB-231 cells for 24 h. The wound healing assay revealed that after 24 h of coculture with MDA-MB-231 cells, the CAF coculture group exhibited a significantly higher migration rate (38.86%) than the negative control (25.07%, P<0.01) and HMF coculture groups (30.56%, P<0.05). Notably, the migration rate in the CAF-OE-RAB1A coculture group further enhanced to 47.21% relative to that in the CAF coculture group (P<0.05). Additionally, TGF-β1 secretion in the CAF-OE-RAB1A coculture group (1030.56 pg/ml) was markedly elevated relative to that in the CAF (417.62 pg/ml, P<0.001) and HMF coculture groups (29.52 pg/ml, P<0.0001). Conclusion RAB1A is specifically highly expressed in CAFs within the breast cancer TME. It may be involved in the metastatic process of breast cancer. Furthermore, RAB1A can promote TNBC cell migration by regulating the secretory function of CAFs.

Humans ; Aged ; Psychotic Disorders/therapy* ; Acute Disease

Background: Little is known about the views of faculty members who train medical students concerning open disclosure. Objectives: The objectives of this study were to determine the views of faculty in a medical school on: 1 what constitutes a medical error and the severity of such an error in relation to medication use or diagnosis; 2 information giving following such an adverse event, based on severity; and 3 acknowledgement of responsibility, remedial action, compensation, disciplinary action, legal action, and reporting to a higher body in relation to such adverse event. Methods: We adapted and contextualized a questionnaire developed from a previous study. The questionnaire had 4 case vignettes that described 1 clear medication error with lifelong disability; 2 possible diagnostic error with lifelong disability; 3 possible diagnostic error without harm; and 4 clear medication error without harm. We invited all faculty members attached to the medical school at the International Medical University to participate in the study. Results: Seventy faculty members took part. Faculty members viewed a medical error as having taken place depending on how clearly an error had occurred (94% and 73% versus 53% and 27%). They viewed cases as more severe based on the severity of complications (85% and 46% versus 5% and 10%). With increasing severity, they tended to attribute responsibility for the event and the duty to disclose towards more senior clinicians. They were also more agreeable with remedial action, compensation, disciplinary action, and reporting to a higher agency. There was no strong evidence of association between these areas and the demographics of faculty members. Conclusions: Faculty members are more likely to perceive an error had occurred depending on the clarity of the circumstances. They viewed severity based on the presence of complications. Severity determined how they attributed responsibility, duty to disclose, and other areas related to open disclosure.

BACKGROUND: Spinocerebel ar ataxia is a common neurodegenerative disease characterized by slowly progressive movement incoordination of the limbs. It responds badly to common medication. OBJECTIVE: To observe the clinical effect of autologous bone marrow mesenchymal stem cells and al ogeneic umbilical cord mesenchymal stem cells tranfusion in the treatment of spinocerebel ar ataxia. METHODS: A total of 27 spinocerebel ar ataxia patients treated with mesenchymal stem cells treatment were included for comprehensive statistical analysis. Among these patients, six patients received autologous bone marrow mesenchymal stem cells lumbar puncture treatment and 21 patients received al ogeneic umbilical cord mesenchymal stem cells lumbar puncture treatment combined with intravenous infusion. The neurologic function of the patients in the two groups was evaluated with International Cooperative Ataxia Rating Scale before and after treatment. RESULTS AND CONCLUSION: There was no obvious adverse effect in the 27 spinocerebel ar ataxia patients during, before or after mesenchymal stem cells treatment. The effect of autologous bone marrow mesenchymal stem cells in six patents was not significant; for the other 21 patients treated with al ogeneic umbilical cord mesenchymal stem cells transfusion, the subjective symptoms of the patients were improved, and the International Cooperative Ataxia Rating Scale scores were decreased significantly at 3 months after treatment when compared with those before treatment (P < 0.05). The results suggest that umbilical cord mesenchymal stem cells treatment is safe and able to ameliorate the clinical symptoms and improve life quality of spinocerebel ar ataxia patients to some extent.

OBJECTIVE: To evaluate the nature and imaging appearance of incidental enhancing breast lesions detected on a routine contrast-enhanced chest CT. MATERIALS AND METHODS: Twenty-three patients with incidental enhancing breast lesions on contrast-enhanced chest CT were retrospectively reviewed. The breast lesions were reviewed by unenhanced and enhanced CT, and evaluated by observing the shapes, margins, enhancement patterns and backgrounds of breast lesions. A histopathologic diagnosis or long-term follow-up served as reference standard. RESULTS: Sixteen (70%) patients had malignant breast lesions and seven (30%) had benign lesions. In 10 patients, the breast lesions were exclusively detected on contrast-enhanced CT. Using unenhanced CT, breast lesions with fibroglandular backgrounds were prone to be obscured (p < 0.001). Incidental primary breast cancer showed an non-significant trend of a higher percentage irregular margin (p = 0.056). All of the four incidental breast lesions with non-mass-like enhancement were proven to be malignant. CONCLUSION: Routine contrast-enhanced chest CT can reveal sufficient details to allow for the detection of unsuspected breast lesions, in which some cases may be proven as malignant. An irregular margin of incidental enhancing breast lesion can be considered a suggestive sign of malignancy.
Aged ; Breast Diseases/radiography ; Breast Neoplasms/*radiography/secondary ; *Contrast Media ; Female ; Humans ; *Incidental Findings ; Iohexol/*analogs & derivatives/diagnostic use ; Middle Aged ; *Radiography, Thoracic ; *Tomography, X-Ray Computed

A 58-year-old male patient presented with a recurrent true malignant mixed tumor of the parotid gland. Patchy pulmonary opacities were identified with a chest radiograph. Subsequently, a CT scan of the chest showed pulmonary parenchymal consolidation with amorphous calcifications. This abnormality was confirmed to be the result of a metastatic true malignant mixed tumor by using CT-guided biopsy. The current case demonstrated an extremely rare example of atypical pulmonary metastases from a true malignant mixed tumor of the parotid gland showing an air-space pattern and calcification.
Biopsy, Fine-Needle ; Humans ; Lung Neoplasms/*secondary ; Male ; Middle Aged ; Mixed Tumor, Malignant/*pathology ; Parotid Neoplasms/*pathology ; Radiography, Interventional ; Tomography, X-Ray Computed

The proportion and changes of CD4+CD25high regulatory T cells (Trs) in peripheral blood of non-small cell lung cancer (NSCLC) patients were analyzed and their clinical significance explored. The peripheral blood was collected from 61 patients with NSCLC and 15 healthy controls. By using monoclonal antibodies, the blood samples were evaluated with the flow cytometry for lymphocyte subsets (CD3+, CD4+ and CD8+) and CD4+CD25high Tr cells. The results showed that the proportion of CD4+CD25high Tr cells in NSCLC group was significantly higher than in control group [(4.36 +/-2.07) % vs (2.04+/-1.03) %, P<0.01]. The proportion of CD4+CD25 high Tr cells in late stage was higher than that in early stage [stages I +II (2.26+/-0.6) %; stage III (3.28+/-1.38) %; stage IV (6.06 +/-4.08) %] (P<0.05). Kaplan-Meier survival analysis revealed that the prognosis of the patients who had higher proportion of CD4+CD25high Tr cells in peripheral blood was worse (P=0.0026). In conclusion, the relative increase in CD4+CD25high Tr cells in peripheral blood may be related to immunosuppression and tumor progression in patients with NSCLC. This finding suggests that CD4+CD25+high Tr cells in peripheral blood of NSCLC may be positive for prognosis analysis. The use of depletion of the CD4+CD25high Tr cell therapy to treat NSCLC patients may be an effective strategy.

The proportion and changes of CD4+CD25high regulatory T cells (Trs) in peripheral blood of non-small cell lung cancer (NSCLC) patients were analyzed and their clinical significance explored. The peripheral blood was collected from 61 patients with NSCLC and 15 healthy controls. By using monoclonal antibodies, the blood samples were evaluated with the flow cytometry for lymphocyte subsets (CD3+, CD4+ and CD8+) and CD4+CD25high Tr cells. The results showed that the proportion of CD4+CD25high Tr cells in NSCLC group was significantly higher than in control group [(4.36±2.07) % vs (2.04±1.03) %, P＜0.01]. The proportion of CD4+CD25 high Tr cells in late stage was higher than that in early stage [stages Ⅰ + Ⅱ (2.26±0.6) %; stage Ⅲ (3.28±1.38) %; stage Ⅳ(6.06±4.08) %] (P＜0.05). Kaplan-Meier survival analysis revealed that the prognosis of the patients who had higher proportion of CD4+CD25high Tr cells in peripheral blood was worse (P=0.0026). In conclusion, the relative increase in CD4+CD25high Tr cells in peripheral blood may be related to immunosuppression and tumor progression in patients with NSCLC. This finding suggests that CD4+CD25+high Tr cells in peripheral blood of NSCLC may be positive for prognosis analysis. The use of depletion of the CD4+CD25high Tr cell therapy to treat NSCLC patients may be an effective strategy.

Objective: To investigate the frequencies of CD4+ regulatory T(Treg) cells(CD4+CD25+/CD4+CD25high) in peripheral blood of cancer patients,providing the opportunity to determine whether cancer patients exhibit an expanded CD4+CD25high pool. Methods: The frequency of CD4+CD25+/CD4+CD25high Treg in the peripheral blood of 62 cancer patients and 15 controls was determined by flow cytometry. Results: Compared with those of healthy control, the frequency of CD4+CD25+/CD4+CD25high in the peripheral blood of cancer patients showed a significant increase[(19.61?8.17)%/(4.20?1.90)%,P