Purpose: This Phase II trial was objected to evaluate the efficacy and safety of adding fulvestrant to neoadjuvant chemotherapy in patients with estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)– locally advanced breast cancer (LABC). Additionally, the study aimed to investigate the association of 16α-18F-fluoro-17β-fluoroestradiol (18F-FES) positron emission tomography (PET)–computed tomography (CT) and metabolites with efficacy. Materials and Methods: Fulvestrant and EC-T regimen were given to ER+/HER2– LABC patients before surgery. At baseline, patients received 18F-FES PET-CT scan, and plasma samples were taken for liquid chromatography–mass spectrometry analysis. The primary endpoint was objective response rate (ORR). Secondary endpoints included total pathologic complete response (tpCR) and safety. Results: Among the 36 patients enrolled, the ORR was 86.1%, the tpCR rate was 8.3%. The incidence of grade ≥ 3 treatment-emergent adverse events was 22%. The decrease in ER value in sensitive patients was larger than that in non-sensitive patients, as was Ki-67 (p < 0.05). The maximum standardized uptake value, mean standardized uptake values, total lesion ER expression of 18F-FES PET-CT in sensitive patients were significantly higher than those in non-sensitive patients (p < 0.05). Moreover, these parameters were significantly correlated with Miller and Payne grade and the change in ER expression before and after treatment (p < 0.05). Thirteen differential expressed metabolites were identified, which were markedly enriched in 19 metabolic pathways. Conclusion This regimen demonstrated acceptable toxicity and encouraging antitumor efficacy. 18F-FES PET-CT might serve as a tool to predict the effectiveness of this therapy. Altered metabolites or metabolic pathways might be associated with treatment response.

Purpose: This Phase II trial was objected to evaluate the efficacy and safety of adding fulvestrant to neoadjuvant chemotherapy in patients with estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)– locally advanced breast cancer (LABC). Additionally, the study aimed to investigate the association of 16α-18F-fluoro-17β-fluoroestradiol (18F-FES) positron emission tomography (PET)–computed tomography (CT) and metabolites with efficacy. Materials and Methods: Fulvestrant and EC-T regimen were given to ER+/HER2– LABC patients before surgery. At baseline, patients received 18F-FES PET-CT scan, and plasma samples were taken for liquid chromatography–mass spectrometry analysis. The primary endpoint was objective response rate (ORR). Secondary endpoints included total pathologic complete response (tpCR) and safety. Results: Among the 36 patients enrolled, the ORR was 86.1%, the tpCR rate was 8.3%. The incidence of grade ≥ 3 treatment-emergent adverse events was 22%. The decrease in ER value in sensitive patients was larger than that in non-sensitive patients, as was Ki-67 (p < 0.05). The maximum standardized uptake value, mean standardized uptake values, total lesion ER expression of 18F-FES PET-CT in sensitive patients were significantly higher than those in non-sensitive patients (p < 0.05). Moreover, these parameters were significantly correlated with Miller and Payne grade and the change in ER expression before and after treatment (p < 0.05). Thirteen differential expressed metabolites were identified, which were markedly enriched in 19 metabolic pathways. Conclusion This regimen demonstrated acceptable toxicity and encouraging antitumor efficacy. 18F-FES PET-CT might serve as a tool to predict the effectiveness of this therapy. Altered metabolites or metabolic pathways might be associated with treatment response.

Purpose: This Phase II trial was objected to evaluate the efficacy and safety of adding fulvestrant to neoadjuvant chemotherapy in patients with estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)– locally advanced breast cancer (LABC). Additionally, the study aimed to investigate the association of 16α-18F-fluoro-17β-fluoroestradiol (18F-FES) positron emission tomography (PET)–computed tomography (CT) and metabolites with efficacy. Materials and Methods: Fulvestrant and EC-T regimen were given to ER+/HER2– LABC patients before surgery. At baseline, patients received 18F-FES PET-CT scan, and plasma samples were taken for liquid chromatography–mass spectrometry analysis. The primary endpoint was objective response rate (ORR). Secondary endpoints included total pathologic complete response (tpCR) and safety. Results: Among the 36 patients enrolled, the ORR was 86.1%, the tpCR rate was 8.3%. The incidence of grade ≥ 3 treatment-emergent adverse events was 22%. The decrease in ER value in sensitive patients was larger than that in non-sensitive patients, as was Ki-67 (p < 0.05). The maximum standardized uptake value, mean standardized uptake values, total lesion ER expression of 18F-FES PET-CT in sensitive patients were significantly higher than those in non-sensitive patients (p < 0.05). Moreover, these parameters were significantly correlated with Miller and Payne grade and the change in ER expression before and after treatment (p < 0.05). Thirteen differential expressed metabolites were identified, which were markedly enriched in 19 metabolic pathways. Conclusion This regimen demonstrated acceptable toxicity and encouraging antitumor efficacy. 18F-FES PET-CT might serve as a tool to predict the effectiveness of this therapy. Altered metabolites or metabolic pathways might be associated with treatment response.

Pregnancy ; Female ; Humans ; Placenta ; Nuclear Transfer Techniques ; Embryo, Mammalian ; Cell Nucleus

Adolescent ; Adult ; Brain ; abnormalities ; pathology ; physiopathology ; Child ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Nerve Net ; pathology ; physiopathology ; Schizophrenia ; etiology ; physiopathology ; Schizophrenic Psychology

AIM To observe the clinical role for Supplemented Xijiao Powder (Bubali cornu,Coptidis Rhizoma,Cimicifugae Rhizoma,etc.) in management of hepatitis B virus (HBV) associated acute-on-chronic liver failure.METHOD Seventy-five patients,including the ones receiving internal medicine treatment,were divided into control group and experimental group.The experimental group received conventional treatment and additionally took Supplemented Xijiao Powder for one month.The clinical symptoms and signs were observed.Levels of ALT,AST,TBIL,ALB,CHE,PTA were measured,and the incidence of liver failure was evaluated.RESULTS Supplemented Xijiao Powder could improve symptoms,signs and the level of PTA.The incidence of liver failure tended to reduce.The comparison of other indexes had no marked difference.CONCLUSION Supplemented Xijiao Powder has a certain therapeutic effect on HBV associated prioracute-on-chronic liver failure.Its mechanism may be related to blocking the occurrence of liver failure.

Objective To compare the uniformity between spine MRI and 18F-FDG PET/CT in detection of spinal metastatic tumor, and to analyze the reasons for the discrepancy between them.Methods Data of 42 malignant tumor patients underwent spine MRI and 18F-FDG PET/CT were analyzed retrospectively.And the two tests were underwent within 30 days.The author censused and analyzed the number of centrums with metastatic tumor detected by spine MRI and 18F-FDG PET/CT,and supposed that 18F-FDG PET/CT was gold standard,to evaluate the sensitivity and specificity of spine MRI.The inconsistent between two tests was analysed.Results The study included 509 centrums of 42 patients.123 positive centrums (24.2%) were detected on spine MRI,and 114 positive centrums (22.4%) on 18F-FDG PET/CT(P=0.22>0.05).The uniformity between two tests was good (Kappa=0.76).Supposing that 18F-FDG PET/CT was gold standard,the sensitivity,specificity,positive predictive value, negative predictive value,false negative rate and false positive rate of spine MRI was 85.1%(97/114),93.4%(369/395),85.1%(97/114),93.4% (369/395),14.9%(17/114) and 6.6%(26/395) respectively.43 centrums of 14 patients were diagnosed inconsistently by spine MRI and 18F-FDG PET/CT.The main reasons for the inconformity were as following: types of primary tumors, insensitivity of spine MRI for diffuse scattered spinal metastatic tumors, the existence of misdiagnosis on spine MRI, misdiagnosis of spine MRI for metastatic lesions located in the vertebral appendix and paramedian vertebral body,misdiagnosis of 18F-FDG PET/CT for metastatic lesions located in the sacral centrum, existence of false positive on 18F-FDG PET/CT and so on.Conclusion The uniformity between spine MRI and 18F-FDG PET/CT is good.The inconformity still existes in some cases.Carefully comparative analysis of them contributes to find metastatic lesions.

Objective To explore the microstructural changes of brain white matter in first-episode of childhood and adolescence-onset schizophrenia and the relationship between the fractional anisostrapy (FA)values and cognitive function in patients.Methods This study was a case-control study,40 childhood and adolescence-onset schizophrenia patients aged 10-16 years 35 healthy children with sex,age,education and race matched to controls were chosen. All the subjects were conducted diffusion tensor imaging (DTI) scans, then using tract-based spatial statistics (TBSS) method to compare FA values of white matter fiber. The cognitive function was assessed with the (MATRICS Consensus Cognitive Battery,MCCB). The relationship between the FA values of different white matter and the cognitive function in the two group was analysed by using Pearson correlation analysis. Results Compared with the controls(n=34), FA values of patients(n=35) in the body of corpus callosum, genu of corpus callosum, splenium of corpus callosum, cingulum bundle, right upper corona radiate, upper left corona radiate significantly decreased (t=4.726, 2.855,2.547,2.943,3.178,2.969,all P<0.05).The FA values of the body of corpus callosum were positively correlated with the symbol coding, color, color words(r=0.34, 0.38, 0.36, all P<0.05) in patients. The FA value of the cingulum bundle were positively correlated with the Hapkins Verbal Learning Test-Revised (HVLT-R),the FA value of the upper left corona radiate were positively correlated with the Word fluency(r=0.34,0.37,both P<0.05).In the controls FA value of white matter in the body and genu of corpus callosum were positively correlated with the HVLT-R(r=0.34,0.51,both P<0.05).Conclusions The childhood and adolescence-onset schizophrenia showed microstructural changes in the brain regional white matter, the pathophysiological mechanism of cognitive impairment may be related to the abnormalities of the brain white matter microstructural structure.

Objective To explore the microstructural changes of brain white matter in first-episode of childhood and adolescence-onset schizophrenia and the relationship between the fractional anisostrapy (FA)values and cognitive function in patients.Methods This study was a case-control study,40 childhood and adolescence-onset schizophrenia patients aged 10-16 years 35 healthy children with sex,age,education and race matched to controls were chosen. All the subjects were conducted diffusion tensor imaging (DTI) scans, then using tract-based spatial statistics (TBSS) method to compare FA values of white matter fiber. The cognitive function was assessed with the (MATRICS Consensus Cognitive Battery,MCCB). The relationship between the FA values of different white matter and the cognitive function in the two group was analysed by using Pearson correlation analysis. Results Compared with the controls(n=34), FA values of patients(n=35) in the body of corpus callosum, genu of corpus callosum, splenium of corpus callosum, cingulum bundle, right upper corona radiate, upper left corona radiate significantly decreased (t=4.726, 2.855,2.547,2.943,3.178,2.969,all P<0.05).The FA values of the body of corpus callosum were positively correlated with the symbol coding, color, color words(r=0.34, 0.38, 0.36, all P<0.05) in patients. The FA value of the cingulum bundle were positively correlated with the Hapkins Verbal Learning Test-Revised (HVLT-R),the FA value of the upper left corona radiate were positively correlated with the Word fluency(r=0.34,0.37,both P<0.05).In the controls FA value of white matter in the body and genu of corpus callosum were positively correlated with the HVLT-R(r=0.34,0.51,both P<0.05).Conclusions The childhood and adolescence-onset schizophrenia showed microstructural changes in the brain regional white matter, the pathophysiological mechanism of cognitive impairment may be related to the abnormalities of the brain white matter microstructural structure.

Objective To investigate the core competence of humanistic quality of the surgical nurses in primary hospitals ,therefore to detect problems and find corresponding solutions .Methods Based on the scale of core competence of registered nurses of China , we adopted the method of stratified cluster sampling , and choose one grade-three comprehensive hospital , two grade-two comprehensive hospitals and conducted the survey among 189 surgical nurses .The competence difference was compared between nurses of different professional titles and hospitals , and the correlation analysis was made .Results Among the 189 nurses surveyed , the average scores of the critical thinking and scientific research , ethics and legal practice , interpersonal relationship, and education and consultation were (21.32 ±2.54),(20.49 ±1.56),(20.75 ±1.67), (17.81 ±2.20)respectively, with the scoring rates of 53.3%,64.0%,64.8%, and 63.6%respectively.The scores of the senior nurses were higher than those of the junior and intermediate nurses with statistical significance (F=78.814,P<0.01).In terms of interpersonal relationship and ethics and legal practice the scores in grade-three hospitals were higher than those in the grade-two hospitals with statistical significance ( t=2.603,2.249,respectively;P<0.01).The four items of core competence of humanistic quality in the surgical nurses of primary hospitals were positively correlated ( P <0.01 ).Conclusions The core competence of humanity quality of the surgical nurses was comparatively low , with the phenomenon more obvious in junior and intermediate nurses .The cooperation between hospitals and colleges and universities should be promoted so as to strengthen the education on the core competence of humanistic quality in the students .Meanwhile long-term training programs should be implemented by hospitals to give stratified education on the core competence of humanistic quality .