ObjectiveTo investigate the differences between indocyanine green (ICG) plus methylene blue and radioactive nuclide plus methylene blue for sentinel lymph node biopsy (SLNB) after Neoadjuvant chemotherapy (NAC) in breast cancer patients. Methods A total of 77 breast cancer patients who accepted SLNB and axillary lymph node dissection (ALND) after NAC from June 2017 to February 2019 were involved, among them, 46 breast cancer patients accepted SLNB by ICG plus methylene blue and 31 breast cancer patients accepted SLNB by radioactive nuclide plus methylene blue, pathological and clinical data were collected and analyzed.ResultsThere were 43 patients in the ICG plus methylene blue group and 30 patients in radioactive nuclide plus methylene blue group, which totally 73 patients were detected at least one sentinel lymph node in all the 77 patients, and the detection rate was 94.80%. The SLN detected rate, SLN detected numbers, sensitivity, false negative rate, and accuracy of the ICG plus methylene blue group were 93.48% (43/46), 2.32 per case, 82.61% (19/23), 17.39% (4/23), and 90.70% (39/43) respectively, as well as 96.77% (30/31), 2.6 per case, 83.33% (10/12), 16.67% (2/10), and 93.33% (28/30) in the radioactive nuclide plus methylene blue group. There was no significant difference between the ICG plus methylene blue group and radioactive nuclide plus methylene blue group in terms of SLN detected rate, SLN detected numbers, sensitivity, false negative rate, and accuracy (P>0.05).ConclusionICG plus methylene blue showed similar SLN detection rate, SLN detected numbers, sensitivity, false negative rate, and accuracy as radioactive nuclide plus methylene blue for SLNB in breast cancer patients after NAC, and both of them can be performed easily and conveniently.
Objective To explore the potential mechanism of Shuganning injection for non-alcoholic fatty liver disease (NAFLD) through network pharmacology and molecular docking techniques. Methods Information on the active compounds of Shuganning injection and their target proteins, as well as disease-related targets of NAFLD, were collected from multiple public databases from May 23rd to 28th, 2024, for protein interaction network analysis and pathway enrichment analysis. A multi-level network of “herb-compound-target-disease” of Shuganning injection for NAFLD was constructed. Molecular docking was performed on the top 5 key active compounds ranked in the degree centrality of the “core target-active compound” network and the core action targets. Results Finally, 140 active compounds of Shuganning injection and 486 potential targets, 1058 NAFLD-related targets, 154 common targets for NAFLD and Shuganning injection were obtained. Topological analysis of the common target protein interaction network identified 16 key target proteins of protein kinase B1, peroxisome proliferator-activated receptor alpha, peroxisome proliferator-activated receptor gamma, sterol regulatory element-binding protein 1, interleukin-6, and matrix metalloproteinase-9, etc. The gene ontology enrichment analysis showed that their genes were involved in 179 biological processes, 13 cellular components, and 48 molecular functions. The Kyoto Encyclopedia of Genes and Genomes enrichment analysis showed that their genes were involved in 99 pathways of cancer, lipid and atherosclerosis, NAFLD and insulin resistance, etc. The constructed multi-level network of “herb-compound-target-disease” consisted of 102 nodes and 208 edges. The molecular docking results showed that the 5 key active compounds of baicalin, acacetin, sitosterol, β-sitosterol, and ganoderic acid A had high affinity for the core target proteins. Conclusion Shuganning injection may exert therapeutic effects on NAFLD through active compounds like baicalin, acacetin, sitosterol, β-sitosterol and ganoderic acid A, acting on key target proteins such as protein kinase B1, peroxisome proliferator-activated receptor alpha, peroxisome proliferator-activated receptor gamma, sterol regulatory element-binding protein 1, interleukin-6, and matrix metalloproteinase-9, regulating pathways related to lipids and atherosclerosis, NAFLD, and insulin resistance.
Objective To evaluate the effect of internal fixation on the stability of pedicled fascial flap and the osteogenesis of exceed critical size defect (ECSD) of bone so as to provide theory for the clinical application by the radiography and histology observation. Methods The ECSD model of the right ulnar midshaft bone and periosteum defect of 1 cm in length was established in 32 New Zealand white rabbits (aged 4-5 months), which were divided into group A and group B randomly (16 rabbits in each group). The composite tissue engineered bone was prepared by seeding autologous red bone marrow (ARBM) on osteoinductive absorbing material (OAM) containing bone morphogenetic protein and was used repair bone defect. A pedicled fascial flap being close to the bone defect area was prepared to wrap the bone defect in group A (control group). Titanium miniplate internal fixation was used after defect was repair with composite tissue engineered bone and pedicled fascial flap in group B (experimental group). At 2, 4, 6, and 8 weeks, the X-ray films examination, morphology observation, and histology examination were performed; and the imaging 4-score scoring method and the bone morphometry analysis was carried out. Results All rabbits survived at the end of experiment. By X-ray film observation, group B was superior to group A in the bone texture, the space between the bone ends, the radiographic changes of material absorption and degradation, osteogenesis, diaphysis structure formation, medullary cavity recanalization. The radiographic scores of group B were significantly higher than those of group A at different time points after operation (P lt; 0.05). By morphology and histology observation, group B was superior to group A in fascial flap stability, tissue engineered bone absorption and substitution rate, external callus formation, the quantity and distribution area of new cartilage cells and mature bone cells, and bone formation such as bone trabecula construction, mature lamellar bone formation, and marrow cavity recanalization. The quantitative ratio of bone morphometry analysis in the repair area of group B were significantly larger than those of group A at different time points after operation (P lt; 0.05). Conclusion The stability of the membrane structure and the bone defect area can be improved after the internal fixation, which can accelerate bone regeneration rate of the tissue engineered bone, shorten period of bone defect repair, and improve the bone quality.
ObjectiveTo investigate the clinical value of magnetic resonance imaging (MRI) combined with ultrasound (US) contrasting with MRI in evaluating the pathological complete response (pCR) of breast cancer after neoadjuvant chemotherapy (NAC).MethodsThe imaging data of patients with primary invasive breast cancer who completed the surgical resection after NAC and met the inclusion criteria in the Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qingdao University from December 2016 to December 2019 were collected retrospectively. These patients were evaluated by MRI and MRI combined with US examination respectively. The results of MRI alone and MRI combined with US were designed into imaging of complete remission (rCR) and imaging of non-complete remission (non-rCR). With results of postoperative pathology as the gold standard, the sensitivity, specificity, and positive predictive value (PPV) of MRI alone and MRI combined with US in predicting pCR of patients with rCR or non-rCR were calculated and which were further analyzed in the 4 subtypes of breast cancer (HR+/HER2+, HR+/HER2–, HR–/HER2+, and HR–/HER2– subtype).Results① According to the inclusion and exclusion criteria, a total of 146 patients with primary invasive breast cancer were included, including 34 cases of HR+/HER2+subtype, 63 cases of HR+/HER2– subtype, 23 cases of HR–/HER2+ subtype, and 26 cases of HR–/HER2– subtype. ② After NAC, 36 cases had a pCR, among which 9 cases (26.5%) were in HR+/HER2+ subtype, 10 cases (15.9%) were in HR+/HER2– subtype, 8 cases (34.8%) were in HR–/HER2+ subtype, and 9 cases (34.6%) were in HR–/HER2– subtype. ③ After NAC, 22 (78.6%) of the 28 patients evaluated by MRI alone achieved pCR, 17 (81.0%) of the 21 patients evaluated by MRI combined with US achieved pCR, and the PPV value of pCR evaluated by MRI alone and MRI combined with US was 78.6% and 81.0%, respectively. ④ Both MRI alone and MRI combined with US predicted NAC showed the highest PPV values in patients with HR–/HER2– subtype breast cancer (85.7% and 100%, respectively), and the lowest values in HR+/ HER2– subtype breast cancer (71.4% and 60.0%, respectively).ConclusionFor the overall patients with primary invasive breast cancer, MRI combined with US is superior to MRI alone in the evaluation of efficacy after NAC, and among the patients with different subtypes of breast cancer, except HR+/HER2– subtype, MRI combined with US is still more effective in predicting efficacy after NAC than MRI alone.
Objective To summarize and analyze the application value of triple stomach shaping technique in laparoscopic sleeve gastrectomy (LSG). Methods The clinical data of patients undergoing simple LSG with triple stomach shaping technique carried out by the General Surgery Obesity and Metabolic Diseases Center of Chengdu Third People’s Hospital from January to December 2021 were retrospectively collected, recording the operative time and the occurrence of recent complications such as postoperative nausea/vomiting, gastric leakage, bleeding, obstruction/torsion within 30 days after operation. Results A total of 966 patients were collected, including 294 males and 672 females. The age was 16–65 years, average age was (32.8±8.6) years. Body mass index was 27.5–47.2 kg/m2, average was (34.2±3.5) kg/m2. All operations were successfully completed without conversion to laparotomy. The operative time was 45–170 min, average was (100.2+33.4) minutes. Postoperative nausea/vomiting occurred in 484 cases (50.10%), bleeding in 2 cases (0.21%, intraperitoneal bleeding in 1 case, intragastric bleeding in 1 case), gastric leakage in 1 case (0.10%, grade B leakage), and no perioperative death occurred. Hospitalization time was 4–24 d, average was (7.55±2.47) d. Two patients (0.21%) were hospitalized again due to nausea and vomiting within 30 days after operation, they were relieved and discharged after conservative medical treatment. Conclusion Triple gastric shaping technology is more physiological, safe and suitable for promotion.
Objective To analyze the disease burden of liver cancer caused by nonalcoholic steatohepatitis (NASH) among the Chinese population by utilizing the latest global burden of disease (GBD) 2021 data, and conduct a comparative analysis with the global situation, so as to provide references and lessons for the formulation of public health policies and disease management plans in China. Methods GBD 2021 database publicly released in May 2024 was searched and relevant disease burden data of liver cancer caused by NASH in China and globally from 1990 to 2021 was sorted out. Joinpoint regression model was employed to calculate the average annual percentage change (AAPC) of the age-standardized rates of various burden indicators in order to evaluate the changing characteristics of disease epidemiology over time. Meanwhile, Bayesian method was used to predict the number of incidences and deaths of liver cancer caused by NASH in China and globally from 2022 to 2045. Results Compared with 1990, in 2021, the number of incidences, prevalence, deaths, disability-adjusted life years, age-standardized incidence rate and age-standardized prevalence rate of liver cancer caused by NASH in the overall, male and female populations in China and globally all increased. Moreover, in 1990 and 2021, all the burden indicators of the Chinese male population were higher than those of the female population in the corresponding years. The overall trend analysis showed that during the 32 years from 1990 to 2021, the age-standardized incidence rate [AAPC=0.44%, 95%CI (0.35%, 0.53%), P<0.001] and the age-standardized prevalence rate [AAPC=0.92%, 95%CI (0.73%, 1.11%), P<0.001] of liver cancer caused by NASH in the overall population in China both showed a significant upward trend. In addition, in 1990 and 2021, the age-standardized rates of all the burden indicators of the overall population in China were higher than the global levels in the corresponding years. The prediction results of the Bayesian model showed that from 2022 to 2045, the number of incidences and deaths of liver cancer caused by NASH in the overall, male and female populations in China and globally will generally show an upward trend. Conclusions The disease burden of liver cancer caused by NASH in China and globally is generally on the rise. In order to curb the increasing disease burden, it is necessary to formulate relevant public health policies and disease management plans in a timely manner.
Surrogate endpoints, defined as biomarkers or intermediate outcomes utilized in clinical trials to replace the ultimate targeted outcomes, have witnessed a growing prevalence in both clinical trials and drug-device approvals in recent years. To standardize the application and reporting of surrogate endpoints in clinical trial protocols and associated studies, relevant scholars published the SPIRIT-Surrogate and CONSORT-Surrogate reporting guidelines in the BMJ in July 2024. This article provides an interpretation of these guidelines in conjunction with published case studies, with the aim of offering references for domestic researchers, elevating the overall quality of related clinical trials, and eventually facilitating the enhancement of domestic healthcare level.