Background::Sentinel lymph node (SLN) biopsy is gradually accepted as the standard of care in breast cancer patients with down-staged axillary disease after neoadjuvant chemotherapy (NAC). However, it is still difficult to precisely define pre-NAC clinical node-positive (cN1) and post-NAC clinical node-negative (ycN0). This prospective single-center trial was designed to evaluate the feasibility and accuracy of standard targeted axillary dissection (TAD) after NAC in highly selective pre-NAC cN1 patients (not considering ultrasound-based axillary ycN staging).Methods::This prospective trial included patients with initial pre-NAC cT1–3N1M0 invasive breast cancer but with a rigorous definition of cN1 from the Affiliated Cancer Hospital of Zhengzhou University. When NAC was effective (including complete and partial responses) and preoperative axillary palpation was negative, preoperative ultrasound-based axillary staging was not considered, and all patients underwent TAD followed by axillary lymph node (LN) dissection. The detection rate (DR) and false-negative rate (FNR) of TAD were calculated.Results::A total of 82 patients were included, and 77 of them were eligible for data analysis. The DR for TAD was 94.8% (73/77). There were 26 patients with one abnormal LN at the time of diagnosis based on ultrasound, 45 patients with two, and 2 patients with three. One patient had one TAD LN, four patients had two TAD LNs, and 68 patients had three or more TAD LNs. Preoperative axillary palpation yielded negative results for all 73 patients who successfully underwent TAD. Preoperative ultrasound-based ycN0 and ycN+ conditions were detected for 52 and 21 cases, respectively. The FNR was 7.4% (2/27) for standard TAD (≥3 SLNs), which was lower than that of all successful TAD (≥1 SLN; 10.0%, 3/30).Conclusions::In rigorously defined pre-NAC cN1 breast cancer patients, standard TAD is feasible for those with negative axillary palpation after NAC, and FNR is also less than 10%.Registration::chictr.org.cn, ChiCTR2100049093

Objective:To investigate the predictive value of stress hyperglycemic ratio (SHR) and hypoperfusion volume for early neurological deterioration (END) in patients with minor stroke due to large vessel occlusion in anterior circulation.Methods:Consecutive patients with minor stroke due to large vessel occlusion in anterior circulation admitted to the Department of Neurology, Zhangjiagang Hospital Affiliated to Soochow University from October 2021 to January 2024 were included retrospectively. Minor stroke was defined as a baseline National Institutes of Health Stroke Scale (NIHSS) score of ≤ 5. SHR was calculated as the fasting blood glucose to glycated hemoglobin ratio, and CT perfusion imaging Tmax >6 s volume represented severe hypoperfusion volume. END was defined as an increase of ≥4 in NIHSS score compared to the baseline within 24 hours of onset. Multivariate logistic regression analysis was used to determine the independent risk factors for END. Receiver operating characteristic (ROC) curves was used to determine the predictive value of each independent predictor for END. Results:A total of 190 patients were enrolled, including 52 females (27.4%), aged 65.89±14.30 years. The baseline NIHSS score was 3 (interquartile range, 2-5). Forty-six patients (24.2%) experienced END, and 22 received salvage endovascular treatment. Univariate analysis showed that there were significant differences in severe hypoperfusion volume, SHR, and the proportion of patients with fasting blood glucose >7 mmol/L between the END group and the non-END group (all P<0.05). Multivariate logistic regression analysis showed that SHR (odds ratio [ OR] 7.736, 95% confidence interval [ CI] 1.082-55.286; P=0.041) and Tmax >6 s volume ( OR 1.006, 95% CI 1.001-1.010; P=0.009) were the independent predictive factors for END. ROC curve analysis showed that area under the curve of SHR and Tmax >6 s volume for predicting END were 0.720 (95% CI 0.632-0.807) and 0.649 (95% CI 0.561-0.737), respectively. The optimal cutoff value for SHR was 1.03, and the sensitivity and specificity were 60.9% and 79.9%, respectively; the optimal cutoff value for Tmax >6 s volume was 38.7 ml, and the sensitivity and specificity were 89.1% and 39.6%, respectively. The area under the curve of combining the two indicators to predict END was 0.736 (95% CI 0.654-0.848). Conclusion:In patients with minor stroke due to large vessel occlusion in anterior circulation, higher SHR and larger severe hypoperfusion volume have certain predictive value for END.

OBJECTIVE: To design and construct a graphene oxide (GO)/silver nitrate (Ag₃PO₄)/chitosan (CS) composite coating for rapidly killing bacteria and preventing postoperative infection in implant surgery. METHODS: GO/Ag₃PO₄ composites were prepared by ion exchange method, and CS and GO/Ag₃PO₄ composites were deposited on medical titanium (Ti) sheets successively. The morphology, physical image, photothermal and photocatalytic ability, antibacterial ability, and adhesion to the matrix of the materials were characterized. RESULTS: The GO/Ag₃PO₄ composites were successfully prepared by ion exchange method and the heterogeneous structure of GO/Ag₃PO₄ was proved by morphology phase test. The heterogeneous structure formed by Ag₃PO₄ and GO reduced the band gap from 1.79 eV to 1.39 eV which could be excited by 808 nm near-infrared light. The photothermal and photocatalytic experiments proved that the GO/Ag₃PO₄/CS coating had excellent photothermal and photodynamic properties. In vitro antibacterial experiments showed that the antibacterial rate of the GO/Ag₃PO₄/CS composite coating against Staphylococcus aureus reached 99.81% after 20 minutes irradiation with 808 nm near-infrared light. At the same time, the composite coating had excellent light stability, which could provide stable and sustained antibacterial effect. CONCLUSION GO/Ag₃PO₄/CS coating can be excited by 808 nm near infrared light to produce reactive oxygen species, which has excellent antibacterial activity under light.
Chitosan ; Silver Nitrate ; Titanium ; Anti-Bacterial Agents/pharmacology* ; Coloring Agents

Objective:To investigate the prognostic value of molecular subtypes in patients with resected invasive breast cancer.Methods:Between 2015 and 2018 7 869 patients with invasive breast cancer after undergoing surgery were included in this analysis. Breast cancer was classified into four subtypes according to the status of hormone receptor (HR) and HER2: HR+/HER2-, HR+/HER2+, HR-/HER2+, and HR-/HER2-. Kaplan-Meier curves and COX regression were used to compare disease-free survival (DFS) and overall survival (OS) among different subtypes.Results:The 5-year DFS and OS were 86.30% and 94.29%, respectively. Proportions of HR+/HER2-、HR+/HER2+、HR-/HER2+ and HR-/HER2- were 52.9%、17.5%、14.1%和15.5%, respectively. The 5-year DFS of HR+/HER2- subtype (88.12%) was higher than HR+/HER2+ (84.67%, P=0.026), HR-/HER2+ (84.19%, P<0.001) and HR-/HER2- (83.70%, P<0.001). The 5-year OS of HR+/HER2- (95.38%) was not different from HR+/HER2+ (95.17%, P=0.187), while it was higher than that of HR-/HER2+ (92.26%, P<0.001) and HR-/HER2- (91.69%, P<0.001). Subtype was still a significant factor regarding DFS and OS in multivariable analyses adjusting for age, sex, stage, Ki67, types and time of surgery. The DFS ( P=0.257) and OS ( P=0.511) was not different between HR-/HER2+与HR+/HER2- subtypes, while HR-/HER2+ and HR-/HER2- patients had worse DFS ( P<0.05) and OS ( P<0.05) than that with HR+/HER2-. Conclusions:Molecular subtype is a significant independent prognostic factor for DFS and OS in operable invasive breast cancer. HR+ subtypes have better prognosis compared with HR- subtypes. The DFS and OS were not different between HR+/HER2- and HR+/HER2+, or between HR-/HER2+ and HR-/HER2-.

With the rapid development of artificial intelligence technology, researchers have applied it to the diagnosis of various tumors in the urinary system in recent years, and have obtained many valuable research results. The article sorted the research status of artificial intelligence technology in the fields of renal tumors, bladder tumors and prostate tumors from three aspects: the number of papers, image data, and clinical tasks. The purpose is to summarize and analyze the research status and find new valuable research ideas in the future. The results show that the artificial intelligence model based on medical data such as digital imaging and pathological images is effective in completing basic diagnosis of urinary system tumors, image segmentation of tumor infiltration areas or specific organs, gene mutation prediction and prognostic effect prediction, but most of the models for the requirement of clinical application still need to be improved. On the one hand, it is necessary to further improve the detection, classification, segmentation and other performance of the core algorithm. On the other hand, it is necessary to integrate more standardized medical databases to effectively improve the diagnostic accuracy of artificial intelligence models and make it play greater clinical value.
Algorithms ; Artificial Intelligence ; Humans ; Male ; Prognosis ; Prostatic Neoplasms/diagnosis* ; Technology

Objective To study the effect of enhancer of rudimentary homolog (ERH) gene on migration and invasion in human bladder cancer T24 and 5637 cells.Methods After knocking out the ERH gene of human bladder cancer T24 and 5637 cells,Wound healing assay,Transwell cell migration assay and Transwell cell invasion assay were used to verify the migration and invasion function.Cell migration related protein was detected by Western blot.Nude mouse tail vein transfer assay was used to study the metastasis ability of bladder cancer cells in vivo.Results (1) The Wound healing assay showed that there were significant differences in the migration cell counts of human bladder cancer 5637 and T24 (P ＜ 0.05).(2) There were significant differences in migration and invasion cell counts of Transwell assay (P ＜0.05).(3) Western blot showed that the expression of E-Cadherin in human bladder cancer 5637 cells and T24 cells was significantly increased (P ＜ 0.05) after knocking out ERH gene,while the expression of Fibronectin,Twist,Vimentin and Snail2 protein were significantly decreased (P ＜ 0.05).(4) Nude mouse tail vein transfer assay showed that lung metastases were significantly reduced in the ERH knockout group compared with the normal ERH group.Conclusions Both in vitro and in vivo experiments suggest that ERH knockout affects the migration and invasion of human bladder cancer T24 and 5637 cells.

OBJECTIVETo investigate the predictive factors affecting sentinel lymph node status in early breast cancer patients.

METHODSClinicopathological data of 1 038 patients with early breast cancer, who underwent sentinel lymph node biopsy in Henan Tumor Hospital between July 2010 and August 2013, were reviewed. Logistic regression analysis was performed to identify the relevance of clinicopathological features with sentinel lymph node metastases.

RESULTSThis group was consisted of 1 038 female patients with an average of 48.6 years. Positive sentinel lymph nodes were found in 22.9% (238/1 038) of the patients. The average number of sentinel lymph nodes removed by surgery was 3.8. Tumor size, tumor location, histopathology, ER/PR status and Ki-67 level were significantly correlated with SLN metastasis(P < 0.05 for all). All the above factors but Ki-67 level were significant independent predictors for SLN metastasis(P < 0.01 for all).

CONCLUSIONNegative hormone receptor status, invasive cancer of non-specific histopathological type, tumor size >2 cm, and tumor location in the outer upper quadrat are independent predictive factors of sentinel lymph node metastasis in patients with early breast cancer.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; surgery ; Female ; Humans ; Ki-67 Antigen ; metabolism ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Retrospective Studies ; Sentinel Lymph Node Biopsy ; Tumor Burden ; Young Adult