Objective:To investigate the correlation between digital breast tomosynthesis(DBT)image features,pathological features,and the results of breast-conserving surgery(BCS)in early stage breast cancer.Methods:We retrospectively analyzed 422 cases of BCS resulting in successful breast preservation and 211 BCS cases that were followed by mastectomy.All of the patients underwent surgery at Tianjin Medical University Cancer Institute&Hospital between January 2019 and December 2023.Preoperative DBT images and clinicopathological features were assessed.A univariate Logistic regression analysis was performed to screen out the characteristics associated with BCS surgic-al results,after which multivariate Logistic regression analysis was performed to screen out the characteristics.Results:Univariate Logistic regression analysis showed that age(P=0.020),architectural distortion(P<0.001),breast composition(extremely dense,P=0.001),and mo-lecular subtype(Her2,P=0.001)were statistically different between the two groups.Multivariate Logistic regression analysis showed that ar-chitectural distortion(P<0.001),breast composition(extremely dense breast,P=0.003),and molecular subtype(Her2,P<0.001)differed signi-ficantly between the two groups.Conclusions:Breast composition,architectural distortion,and molecular subtype correlated with BCS res-ults.Extremely dense breast composition,architectural distortion,and Her2 subtype are associated with a higher possibility of conversion to mastectomy.These factors serve as effective predictive indicators of BCS results and thus aid clinicians in deciding the appropriate surgical strategies in the treatment of breast cancer.

Objective:To investigate the types, incidences, and clinical characteristics of shock in polytrauma patients at different stages after polytrauma.Methods:A retrospective study was conducted on polytrauma patients admitted to multiple trauma centers from June 2020 to December 2021. The inclusion criteria were patients >18 years old and treated due to polytrauma. Exclusion criteria included an admission time of more than 48 h after trauma, a history of malignancy, or metabolic, consumptive, and immunological diseases. The early stage was defined as the period of ≤48 h after polytrauma, and the middle stage was defined as the period between 48 h and 14 days. The patient’s medical history, clinical manifestations, laboratory tests, imaging examination, injury severity score (ISS), and Glasgow coma scale (GCS) were collected. The types, incidences, and clinical characteristics of shock in different stages after polytrauma were analyzed, according to the diagnostic criteria of each type of shock. The differences between the groups were compared by Student’s t test, χ2 test or Mann-Whitney U test. Results:The incidence of the early and middle stage shock after polytrauma were 73.1% and 36.4%, respectively, with statistically significant difference between stages ( P<0.01). There were significant differences in the incidence of hypovolemic shock (83.6% vs. 28.4%), distributed shock (13.7% vs. 80.9%) and cardiogenic shock (3.5% vs. 6.6%) between stages (all P<0.05). The incidence of obstructive shock (8.4% vs. 9.7%, P>0.05) was similar between stages. The incidence of undifferentiated shock was 1.6% and 1.2%, respectively. There were 9.5% patients with multifactorial shock in the early stage and 14.4% in the middle stage. Totally 7 combinations of multifactorial shock were found in different stages after polytrauma. In the early stage, the combination of HS and DS accounted the highest ratio (42.3%) and followed by HS and OS for 28.8%. In the middle stage, the combination of HS and DS was the most common (48.6%) and followed by DS and OS (24.3%). Conclusions:The incidence of shock in polytrauma patients is high. Different types of shock can occur simultaneously or sequentially. Therefore a comprehensive resuscitation strategy is significant to improve the success rate of treatment.

We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female ; Humans ; Uterine Cervical Neoplasms/drug therapy* ; Prospective Studies ; Quality of Life ; Neoplasm Staging ; Chemoradiotherapy ; Chemotherapy, Adjuvant/adverse effects* ; Adjuvants, Immunologic ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Retrospective Studies

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

Tung tree (Vernicia fordii) is an economically important woody oil plant that produces tung oil rich in eleostearic acid. Here, we report a high-quality chromosome-scale genome sequence of tung tree. The genome sequence was assembled by combining Illumina short reads, Pacific Bio-sciences single-molecule real-time long reads, and Hi-C sequencing data. The size of tung tree gen-ome is 1.12 Gb, with 28,422 predicted genes and over 73％ repeat sequences. The V. fordii underwent an ancient genome triplication event shared by core eudicots but no further whole-genome duplication in the subsequent ca. 34.55 million years of evolutionary history of the tung tree lineage. Insertion time analysis revealed that repeat-driven genome expansion might have arisen as a result of long-standing long terminal repeat retrotransposon bursts and lack of efficient DNA deletion mechanisms. The genome harbors 88 resistance genes encoding nucleotide-binding sites;17 of these genes may be involved in early-infection stage of Fusarium wilt resistance. Further, 651 oil-related genes were identified, 88 of which are predicted to be directly involved in tung oil biosynthesis. Relatively few phosphoenolpyruvate carboxykinase genes, and synergistic effectsbetween transcription factors and oil biosynthesis-related genes might contribute to the high oil content of tung seed. The tung tree genome constitutes a valuable resource for understanding genome evolution, as well as for molecular breeding and genetic improvements for oil production.

Objective? To explore the clinical application effects of the spring stiffener for laparoscopic camera cable. Methods? Self-designed laparoscopic camera cable spring reinforcement and the camera was used in clinical practice since January 2017. The maintenance frequency of laparoscopic camera and the operative satisfaction of 49 surgical doctors using the camera were measured between January and December 2016 and between January and December 2017 in the operation room of the First Affiliated Hospital of Wenzhou Medical University. The difference was compared between the two groups before and after improvement. Results? There was statistical difference in the maintenance frequency of the 22 laparoscopic cameras before and after improvement (P＜ 0.05); there was statistical difference in the surgical doctors' overall operative satisfaction, surgical interruption, picture clarity, surgical collaboration and surgical progress (P＜0.05), and the satisfaction after improvement was higher than that before improvement. Conclusions? The spring stiffener for laparoscopic camera cable can not only reduce the frequency of camera maintenance, but also improve the satisfaction of the surgical doctors using the camera, which is worth promoting in clinical practice.

According to clinical PICC(Peripherally Inserted Central Catheter)catheter surgery, this project introduces a new scheme for vein puncturing device and its controlling system. This device adopts ultrasonic image guided by the microcontroller, to achieve automatic venous catheterization. This kind of automatic vein puncture device adopts double stepping motors and screws as its transmission. One motor drives the needle and the hose to puncture into vein through skin. The other one drives the hose to specified location, then triggers withdrawal button and then the needle withdraws back into its cylinder. Several key points were set in the process of puncturing, the velocity period and the acceleration period can be preselected respectively. Moving distance and velocity of the needle in vein puncturing were setup automatically according to diameter and depth of the vein, achieving controlling puncturing and placing hose accurately.

Objective To investigate the synthesis, in vivo biodistribution of 99Tcm-HYNIC-PEG4-E[PEG4-c (RGDfk)] 2 (99 Tcm-Galacto-RGD2), and its potential usage for targeted imaging of mice orthotopic glioma.Methods 99Tcm-Galacto-RGD2 was synthesized straightforward and its radiochemical purity and stability and distribution in mice were analyzed.MicroSPECT-CT imaging was done in a mice orthotopic glioma model, which had been set up with U87MG cells, after administration of 99Tcm-Galacto-RGD2.Region of interest (ROI) of glioma was drawn on SPECT-CT section images to quantify tumor uptake (％ ID/cm3).Glioma was harvested for pathological examination.Linear-regression was used to analyze the relationship between integrin αvβ3 and tumor uptake (％ID/cm3).Results The radiochemical purity of 99Tcm-Galacto-RGD2 was (97.7 ±0.8)％ and stable in vitro.Hynic-Galacto-RGD2 could specifically bind to integrin αv β3 of tumor cells with a IC50 of (18 ± 3) nmol/L.After tail vein injection, 99Tcm-Galacto-RGD2 was rapidly discharged from the blood, liver, kidneys and had a relative low concentration in normal brain tissue.MicroSPECT-CT imaging demonstrated that, after 60 min of injection, this drug was well uptaken by glioma tumor than that after 30 min (t =7.13 ,P ＜0.05), and the tumor to normal brain tissue (T/B) uptake ratio of 99Tcm-Galacto-RGD2 was 13.92± 3.43.Injection of HYNICGalacto-RGD2 2 min prior to 99Tcm-Galacto-RGD2 injection extensively reduced the uptake of radioactive drug in tumor tissue (t =11.36, P ＜ 0.05).Bland-Altman analysis showed that tumor volume based on SPECT-CT imaging measurement had almost same value with the tumor reference volume (95％ CI =-11.94％-11.92％).In addition, the tumor uptake of 99Tcm-Galacto-RGD2 and cellular integrin αvβ3 expression level had a linear relationship (R2 =0.896).Conclusions Stable 99Tcm-Galacto-RGD2 can be synthesized easily and is applicable for microSPECT-CT imaging analysis of orthotopic glioma in mice together with the evaluation of integrin αvβ3 level in tumor.

Objective To compare the clinical results of the ureteral reimplantation with the traditional open approach and laparcocopic pneumovesical approach. Methods A retrospective review of 108 patients who underwent ureteral reimplantation from December 2004 to October 2010 was conducted.The patients were divided into open and pneumovesical groups according to the surgical approach.Perioperative results were compared between the two groups in terms of operative time,postoperative intravenous antibiotics duration,catheterization duration,postoperative stay,average total cost and surgical cost,respectively.And the pneumovesical group was divided into two stages by time,compared the operative time of the two stages and between the later stage and the open group. Results The postoperative hospital stay of pneumovesical group was shorter than the open group (6.8 ± 1.9 d and 8.9 ± 2.9 d,P =0.002 ).For catheterization duration,the pneumovesical group was shorter than the open group as well (5.2 ± 1.2 d and 6.2 ±2.2 d,P=0.057).For the postoperative intravenous antibiotics duration,the pneumovesical group was 5.0 ± 1.3 h,the open group was 5.4 ±1.6 h (P =0.159).For the total cost,the pneumovesical group was 16 067.9 ±4 295.8 RMB,the open group was 15 617.7 ± 5 486.5 R MB (P =0.168).For the surgical cost,the pneumovesical group was 9369.4 ± 1366.6 RMB,the open group was 7397.9 ± 1797.3 RMB ( P =0.083 ).Operative duration of the pneumovesical group and open group were 3.2 ± 1.1 h and 2.3 ± 1.1 h ( P =0.003).For pneumovesical group,the mean operative durations of the two stages were 3.6 h and 2.8 h (P =0.286).And the later stage of pneumovesical group was a little longer than the open group,but no significant difference ( P =0.234 ).No major complication was found in the 2 groups during the operative time and the postoperative hospital stay.Twenty-four patients (38 ureters) of the pneumovesical group were followed up with micturating cystourethrography ( MCU),ureterovesical reflux recurred in 3 patients.Two patients changed from grade Ⅲ to grade Ⅰ and 1 patient changed from grade Ⅴ to grade Ⅲ after the surgery.Five patients (9 ureters) of the open group were followed up,1 patient found bladder diverticulum; 1 patient found ureteral stricture 6 months after the surgery and got improved after secondary ureteral relimplantation surgery. Conclusions The pneumovesical approach is shorter than the open group in postoperative hospital stay and catheterization reserved duration.The pneumovesical approach is a safe and effective option for ureteral reimplantation.

It has been reported that metastasis-associated gene 1 (Mta1) is overexpressed in many malignant tumors with high metastatic potential. In addition, some studies indicated that MTA1 participated in invasion, metastasis, and survival of cancer cells by regulating cell migration, adhesion and proliferation. But the role of MTA1 is unclear in vitro in the development of cervical cancer cells. This study investigated whether and how MTA1 mediated cell proliferation, migration, invasion and adhesion in cervical cancer. MTA1 expression level was detected by Western blot in two cervical cancer cell lines of different invasion potentials. The effects of MTA1 expression on SiHa cell apoptosis, cycle, proliferation, migration, invasion and adhesion were tested by flow cytometry, MTT, wound-healing assay, Transwell assay and adhesion assay, respectively. The expression levels of p53, E-cadherin, and β-catenin activity were evaluated in untreated and treated cells. The results showed that MTA1 protein expression was significantly higher in SiHa than in HeLa, which was correlated well with the potential of migration and invasion in both cell lines. Furthermore, the cell invasion, migration and adhesion capabilities were decreased after inhibition of MTA1 expression mediated by Mta1-siRNA transfection in SiHa. However, no significant differences were found in cell apoptosis, cycle, and proliferation. In addition, E-cadherin and p53 protein levels were significantly up-regulated, while β-catenin was significantly down-regulated in SiHa transfected with the siRNA. These results demonstrated that MTA1 played an important role in the migration and invasion of cervical cancer cells. It was speculated that the decreased migration and invasion capability by inhibiting the MTA1 expression in the SiHa cell line may be mediated through the altered expression of p53, and E-cadherin/β-catenin complex. MTA1 could serve as a potential therapeutic target in cervical cancer.