Cancer Stem Cells and Circulatory Tumor Cells Promote Breast Cancer Metastasis

Breast cancer (BC) is a highly metastatic, pathological cancer that significantly affects women worldwide. The mortality rate of BC is related to its heterogeneity, aggressive phenotype, and metastasis. Recent studies have highlighted that the tumor microenvironment (TME) is critical for the interplay between metastasis mediators in BC. BC stem cells, tumor-derived exosomes, circulatory tumor cells (CTCs), and signaling pathways dynamically remodel the TME and promote metastasis. This review examines the cellular and molecular mechanisms governing the epithelial to mesenchymal transition (EMT) that facilitate metastasis. This review also discusses the role of cancer stem cells (CSCs), tumor-derived exosomes, and CTs in promoting BC metastasis. Furthermore, the review emphasizes major signaling pathways that mediate metastasis in BC. Finally, the interplay among CSCs, exosomes, and CTCs in mediating metastasis have been highlighted. Therefore, understanding the molecular cues that mediate the association of CSCs, exosomes, and CTCs in TME helps to optimize systemic therapy to target metastatic BC.     

Assessment of collateral hand circulation by modified Allen’s test in normal Indian subjects

BackgroundAllen’s test (AT) and Modified Allen’s Test (MAT) are used as screening methods for assessment of the hand circulation. Few people lack the dual blood supply of hand and are at risk of hand ischemia after any intervention on radial artery. The Purpose of the study was to assess the collateral circulation of hand using MAT in normal Indian subjects and in elderly population to know the prevalence of positivity of Allen’s test.Methods900 participants (1800 hands) were divided in two groups. Group I had participants with age <50 years and group II had participants with age ≥50 years. MAT was performed in all participants and results were compared between the two groups.ResultsIn group I (n = 450, 900 hands), 313 were males and 137 were females, with mean age of 35.04 years. The relative percentages of a normal, equivocal, borderline and abnormal MAT were 77.8%, 16.6%, 3.7% and 1.6%, respectively. In group II (n = 450, 900 hands), 248 were males and 202 were females, with mean age of 60.4 years. The relative percentages of a normal, equivocal, borderline and abnormal MAT were 69.0%, 18.6%, 6.60% and 5.66%, respectively. A positive/abnormal test was significantly more common (5.66% Vs 1.66%, P < 0.00001) in older group.ConclusionMAT is simple, time tested and non invasive test to assess collateral circulation of the hand. A negative MAT safely selects patients for radial artery harvest; however, if the test is positive and in older patients then a second objective test may be needed.     

仝小林运用茯苓、生白术、泽泻利脾湿经验

茯苓、生白术、泽泻是仝小林院士临床常用的利脾湿三味小方。仝小林认为,现今多种疾病以脾虚湿困为基本病机。茯苓可利水渗湿,常用剂量为9~120 g;生白术可健脾燥湿,常用剂量为9~90 g;泽泻渗湿化浊,常用剂量为15~30 g。利脾湿三味小方用于代谢性疾病、内分泌、消化系统疾病等有脾湿之证。     

Morphometric analysis of thoracolumbar junction (T11-L2) in central Indian population: A computerized tomography based study of 800 vertebrae

ObjectiveTo determine various morphometric parameters like transverse and sagittal pedicle width; interpedicular distance; antero-posterior and transverse canal diameter and canal surface area at thoracolumbar junction (T11, T12, L1, L2) in central Indian population and compare results with similar studies available in literature.Material and methodsA prospective, computerized tomography scan based morphometric analysis of thoracolumbar junction was conducted at medical college and tertiary care centre in central India. All asymptomatic cases more than 18 years age with normal lateral radiograph and CT scan of thoracolumbar junction and free from any spinal pathology or trauma were included in the study. Parameters measured were transverse and sagittal pedicle width; interpedicular distance; antero-posterior and transverse canal diameter and canal surface area at thoracolumbar junction (T11, T12, L1, L2).ResultsMean transverse pedicle width was maximum at T11 and minimum at L1 in both males and females, whereas sagittal width was maximum at T11 and minimum at L2 in both the groups. Interpedicular distance was largest at L1 in both the groups. All the measurements were significantly different (P < 0.05) in males and females. Mean antero-posterior and transverse diameter was maximum at T12 and L2 respectively in both male and female study population. Canal surface area was maximum at L1 among males (230.10 mm²) as well as females (209.02 mm²).ConclusionThere is significant variation in morphometric parameters of thoracolumbar junction in different races and population. Thorough knowledge of morphometry of a particular population is essential for dealing with pathology or trauma of thoracolumbar junction.