Purpose: Human epidermal growth factor receptor 2 (HER2)-low breast cancer has the potential to emerge as a distinct subtype. Several studies have compared the differences between HER2-low and HER2-0 breast cancers, but no consensus has been reached.Additionally, a biomarker to predict pathological complete response (pCR) rates in patients with HER2-low breast cancer remains to be identified. Methods: We collected data from 777 patients across three centers, stratifying them into HER2-low and HER2-0 groups. We compared differences in survival and pCR rates between the two groups and investigated potential biomarkers that could reliably predict pCR. Results: The study found that patients with HER2-0 breast cancer had higher pCR rates compared to patients with HER2-low tumors (289 patients [30.1%] vs. 475 patients [18.1%], p < 0.0001). Survival analysis showed no significant advantage for HER2-low tumors over HER2-0 breast cancers. Binary logistic analysis revealed that androgen receptor (AR) expression predicts poorer pCR rates in both the overall patient group and the HER2-0 breast cancer group (overall patients: odds ratio [OR], 0.479; 95% confidence interval [CI], 0.250–0.917; p = 0.026 and HER2-0 patients: OR, 0.267; 95% CI, 0.080–0.892; p = 0.032). In contrast, programmed death ligand 1 (PD-L1) expression was associated with more favorable pCR rates in the overall patient group (OR, 3.199; 95% CI, 1.020–10.037; p = 0.046). Conclusion There is currently insufficient evidence to classify HER2-low breast cancer as a distinct subtype. Our study revealed that AR expression, along with negative PD-L1 expression, contributes to lower pCR rates.

Purpose: Human epidermal growth factor receptor 2 (HER2)-low breast cancer has the potential to emerge as a distinct subtype. Several studies have compared the differences between HER2-low and HER2-0 breast cancers, but no consensus has been reached.Additionally, a biomarker to predict pathological complete response (pCR) rates in patients with HER2-low breast cancer remains to be identified. Methods: We collected data from 777 patients across three centers, stratifying them into HER2-low and HER2-0 groups. We compared differences in survival and pCR rates between the two groups and investigated potential biomarkers that could reliably predict pCR. Results: The study found that patients with HER2-0 breast cancer had higher pCR rates compared to patients with HER2-low tumors (289 patients [30.1%] vs. 475 patients [18.1%], p < 0.0001). Survival analysis showed no significant advantage for HER2-low tumors over HER2-0 breast cancers. Binary logistic analysis revealed that androgen receptor (AR) expression predicts poorer pCR rates in both the overall patient group and the HER2-0 breast cancer group (overall patients: odds ratio [OR], 0.479; 95% confidence interval [CI], 0.250–0.917; p = 0.026 and HER2-0 patients: OR, 0.267; 95% CI, 0.080–0.892; p = 0.032). In contrast, programmed death ligand 1 (PD-L1) expression was associated with more favorable pCR rates in the overall patient group (OR, 3.199; 95% CI, 1.020–10.037; p = 0.046). Conclusion There is currently insufficient evidence to classify HER2-low breast cancer as a distinct subtype. Our study revealed that AR expression, along with negative PD-L1 expression, contributes to lower pCR rates.

Purpose: Human epidermal growth factor receptor 2 (HER2)-low breast cancer has the potential to emerge as a distinct subtype. Several studies have compared the differences between HER2-low and HER2-0 breast cancers, but no consensus has been reached.Additionally, a biomarker to predict pathological complete response (pCR) rates in patients with HER2-low breast cancer remains to be identified. Methods: We collected data from 777 patients across three centers, stratifying them into HER2-low and HER2-0 groups. We compared differences in survival and pCR rates between the two groups and investigated potential biomarkers that could reliably predict pCR. Results: The study found that patients with HER2-0 breast cancer had higher pCR rates compared to patients with HER2-low tumors (289 patients [30.1%] vs. 475 patients [18.1%], p < 0.0001). Survival analysis showed no significant advantage for HER2-low tumors over HER2-0 breast cancers. Binary logistic analysis revealed that androgen receptor (AR) expression predicts poorer pCR rates in both the overall patient group and the HER2-0 breast cancer group (overall patients: odds ratio [OR], 0.479; 95% confidence interval [CI], 0.250–0.917; p = 0.026 and HER2-0 patients: OR, 0.267; 95% CI, 0.080–0.892; p = 0.032). In contrast, programmed death ligand 1 (PD-L1) expression was associated with more favorable pCR rates in the overall patient group (OR, 3.199; 95% CI, 1.020–10.037; p = 0.046). Conclusion There is currently insufficient evidence to classify HER2-low breast cancer as a distinct subtype. Our study revealed that AR expression, along with negative PD-L1 expression, contributes to lower pCR rates.

Objective To evaluate the precision and effectiveness of ultrasound-guided visualization for nasojejunal tube placement with the"R(right reclining)-S(shoulder)-A(abdominal)"3-point positioning for critically ill patients.Methods A retrospective analysis was conducted on all critically ill patients who underwent nasojejunal tube placement in Department of Critical Medicine of a tertiary hospital in Chongqing from April 2022 to August 2023.According to the position of the catheter,they were divided into a control group and an observation group.The control group received ultrasound-guided nasojejunal tube insertion,while the observation group used the"R-S-A"3-point positioning (the patient were placed in a right lateral position,the nurse stood at the right shoulder of the patient,and the ultrasound operator stood on the right side of the abdomen in the operating direction)for ultrasound-guided nasojejunal tube insertion.And,the control group had no specific requirements for positioning during the procedure.After propensity matching,the time and success rate of catheter insertion and incidence of complications were compared between the 2 groups.Results The time of catheter insertion was significantly shorter (36.2±10.3 vs 42.3±8.3 min),and the success rate of insertion was obviously higher (95.2％ vs 66.7％)in the observation group when compared with the control group (P<0.05).The incidence of complication was 9.5％ in the observation group,and 28.6％ in the control group,but there was no statistical difference between the 2 groups.Conclusion Ultrasound-guided nasojejunal tube placement based on "R-S-A"3-point positioning has high precision and strong effectiveness in critically ill patients,which can shorten the time and improve the success rate of catheter insertion.

Objective:To investigate the impact of peak pressure upon different bone densities during autonomous puncture by orthopedic robot on puncture path deviation and bone cement leakage.Methods:A spinal surgery robot system was designed for autonomous vertebral puncture and bone cement injection, and six porcine spine specimens were used for single-segment or double-segment simulated percutaneous vertebral augmentation surgery. The accuracy of puncture path (Gertzbein-Robbins grading), bone cement leakage classification, and peak bone drill pressure were measured to assess the accuracy of autonomous vertebral puncture and bone cement leakage in vertebral cortical and cancellous bone of different densities.Results:A total of 64 porcine vertebrae were simulated for puncture, among which 53 vertebrae were classified as Grade A, 8 as Grade B, and 3 as Grade C according to the Gertzbein-Robbins grading. The cortical bone pressure of Grade A vertebrae was 6.663±0.319 N which was lower than that of Grade B (8.348±0.418 N) and Grade C (11.500±0.600 N), with significant differences ( F=341.000, P<0.001). The cancellous bone pressure of Grade A, B, and C vertebrae were 3.660±0.317, 3.594±0.608, and 4.117±0.257 N, respectively, with no significant difference ( F=2.496, P=0.091). There were 40 cases of no leakage, 20 cases of Type I leakage (leakage into the surrounding vertebrae), and 3 cases of Type II leakage (leakage into the vertebral canal), with an overall leakage rate of 36% (23/64). The peak cortical bone pressure for no leakage, Type I, and Type II leakage was 6.638±0.301, 6.792±0.404, and 6.753±0.473 N, respectively, and the peak cancellous bone pressure was 3.634±0.279, 3.783±0.423, and 3.920±0.255 N, respectively, with no significant difference ( F=1.521, P=0.227; F=2.106, P=0.131). Conclusion:During the autonomous puncture process of the novel orthopedic robot, the accuracy of autonomous puncture path decreased when the puncture pressure through the cortical bone was high, and the probability of invading the pedicle increased. The puncture pressure of cortical and cancellous bone had no significant effect on the occurrence rate of bone cement leakage.

Autophagy is the main degradation and recycling pathway for abnormal aggregates and damaged organelles in cells,and it maintains the normal metabolic balance and material renewal in cells.Autophagy has neuroprotective effects and can affect the functional state of the nervous system by regulating homeostasis,development,apoptosis,and other physiological processes of neurons and glial cells.In recent years,a large number of studies have shown that nervous system diseases are closely related to abnormal autophagy,and inhibition or overactivation of autophagy affects the occurrence and development of depression,neurodegenerative diseases,and schizophrenia.Understanding the mechanisms of autophagy in nervous system diseases is of great significance for their prevention and treatment.This paper mainly reviews the current progress of autophagy research and the above diseases of the nervous system,providing a reference for further research into these diseases.

Objective To analyze the clinical efficacy and safety off emoral head replacement(FHR)assisting by the traction table in direct anterior approach(DAA)for the treatment of femur neck fractures in gerontal patients.Methods A retrospective analysis was conducted on 79 elderly patients who under went FHR for femoral neck fractures from March 2019 to July 2020.A total of 42 patients underwent FHR through DAA by using traction table were assigned to the observation group and 37 patients receiving FHR through the PLA to the control group.The perioperative data,follow-up results and complications were compared between the two groups.Results The observation group was significantly superior to the control group in intraoperative blood loss(P<0.05),where as the former was inferior to the latter in preoperative preparation time(P<0.05).There was no significant difference in anesthesia time and operation time between the two groups(P>0.05).The observation group resumed first postoperative standing time,partial-weight bearing walking time and full-weight bearing walk-ing time significantly earlier than control group(P<0.05).Harris score at 1 month after the operation in the observation group were significantly higher than that of the control group(P<0.05),whereas which became not statistical significant between the two groups in 6 months and 1 year(P>0.05).No significant difference was found between the two groups for the incidence of complications(P>0.05).Conclusion DAA-FHR assisting by the traction table for the treatment of femur neck fractures in the elderly was effective and safe,but the preoperative preparation time was longer.

Purpose To investigate the multi-slice spiral CT (MSCT) features ofchromophobe renal cell carcinoma (CCRC),renal oncocytoma (RO) and clear-cell renal cell carcinoma (CCRCC) for the improvement of its diagnostic accuracy.Materials and Methods The MSCT data of 15 CCRC cases,8 RO cases,and 29 CCRCC cases confirmed by surgery or pathology at Dong H ua Hospital from October 2012 to April 2016 were retrospectively studied.The CT signs of different tumors were compared.Results Most CCRCC cases had cystic degenerations,which showed significant difference with CCRC and RO cases (P＜0.05);RO cases were found mostly with star-shaped scars,which had significant difference with CCRCC cases (P＜0.05);the enhanced scanning showed most of CCRC were enhanced homogeneously,which presented significant difference from CCRCC (P＜0.05).The lesion-kidney-ration (LKR) of CCRCC at cortical phase,parenchymal phase or excretory phase was significantly different from that of CCRC (P＜0.05);the LKR of CCRCC at cortical phase was significantly different from that of RO (P＜0.05);the LKR of CCRC at the three phases were all significantly different from that of RO (P＜0.05).The average △ LKR value of CCRCC was significantly different from that of CCRC and RO (P＜0.05);there was a certain degree of difference distribution of their △ LKR among the three kinds of cases.Taking CCRCC as object,when the LKR at cortical phase was 0.693 or △ LKR was 0.068,the sensitivity reached 93.3％ and the specificity reached 72.2％ or 88.9％ respectively in evaluating the differential diagnosis of CCRC and RO.Taking RO as object,when the LKR was 0.656 at cortical phase or was 0.595 at parenchymal phase,the sensitivity reached 83.3％ and 91.7％ respectively,and the specificity was 75.0％ and 58.3％ respectively,in evaluating the differential diagnosis of CCRC.Conclusion Enhanced MSCT at different phases,especially the calculation of LKR and △ LKR value,can benefit the diagnosis of CCRC,RO and CCRCC.

Objective To investigate the prevalence rates of healthcare-associated infection(HAI) and community-associated infection(CAI) in hospitalized patients in Wuhan City, and provide a scientific basis for the prevention and control of HAI.Methods Convenience sampling method was used to select 33 hospitals in Wuhan City, all hospitalized patients were surveyed by bedside investigation and medical record reviewing, SPSS 16.0 software was used for data analysis.Results A total of 36 222 hospitalized patients were investigated, of whom 1 116 (3.08%) had HAI, 6 968 (19.24%) had CAI.The prevalence rate of HAI was highest in hospitals with ≥900 beds(3.40%), and the prevalence rate of CAI was highest in hospitals with<300 beds (43.70%).Of departments, general intensive care unit had the highest prevalence rate of HAI(32.88%), department of respiratory diseases had the highest prevalence rate of CAI (78.34%).A total of 699 pathogens were isolated from patients with HAI, the top three were Pseudomonas aeruginosa (18.03%), Acinetobacter baumannii (16.31%) and Staphylococcus aureus (12.88%), a total of 1 149 pathogens were isolated from patients with CAI, the top three were Escherichia coli (14.45%), Pseudomonas aeruginosa (11.23%), and Mycoplasma (10.01%).The main infected sites of both HAI and CAI were the lower respiratory tract, accounting for 48.24% and 45.15% respectively.Conclusion HAI and CAI have different characteristics, it is necessary to take targeted measures according to key departments and key sites, so as to reduce the occurrence of HAI effectively.

Objective    To investigate the early and mid-term clinical outcomes of the modified cone reconstruction in the treatment of Ebstein’s anomaly (EA). Methods    Clinical data of 18 consecutive patients with EA in our hospital between May 2008 and August 2015 were retrospectively analyzed. All patients were diagnosed by echocardiography. There were 8 males and 10 females with an average age of 20.3 years ranging from 5 to 41 years. According to New York Heart Association classification, 12 patients were classified into grade Ⅱ and 6 grade Ⅲ. One patient had acute arterial embolism and amputation of left lower extremity caused by paradoxical embolism of combined secundum atrial septal defect, and another one was combined with double-orifice technique due to postoperative poor closure of tricuspid valve. The modified cone reconstruction was used to correct the EA, to make leaflets coapted well and form central blood flow. For those patients whose anterior leaflet developed poor and smaller, valve leaflet was widened by using autologous pericardial. For all patients, tricuspid annulus was reinforced by autologous pericardial. Results    Two patients suffered arrhythmia, and returned to normal after medication. The rest patients recovered well without death. Echocardiography found 1 patient with moderate regurgitation and the rest of patients’ leaflets coapted well and had no tricuspid stenosis. They were followed up 9 to 38 months postoperatively, and cardiac function of gradeⅠin 14 patients and gradeⅡin 4 patients. Conclusion    The early and mid-term clinical outcomes of the modified cone reconstruction in the treatment of EA are affirmative which can make leaflets coapt completely and have a strong anti-regurgitation ability, reducing the incidence of re-operation, valve replacement and postoperative mortality.