Breast cancer in young women: Imaging and clinical course

The purpose of this study was to characterize presenting imaging findings in women younger than 40 diagnosed with invasive breast cancer in the context of pathology and clinical course. Retrospective chart and imaging reviews were performed in patients under 40 diagnosed with breast cancer between July 1, 2004, and December 31, 2013. Patient demographic, imaging, pathology, and clinical data were collected. Overall and recurrence-free survival were estimated using the Kaplan-Meier method. Univariate Cox proportional hazards models were performed to identify factors associated with recurrence-free survival. Our study cohort consisted of 110 patients with invasive mammary carcinoma. One hundred one (91.8%) presented with a palpable mass. The mean size of all lesions on imaging was 3.5 cm ± 2.9 cm. Malignant calcifications were present in 54 (49.1%) cases. Imaging demonstrated multifocal or multicentric disease in 45 (40.9%) cases. Seventy four (67.3%) cancers were high grade. Luminal genomic subtypes were the most common (n = 61, 55.5%). At presentation, 4 (3.6%) patients had bilateral malignancy and 8 (7.3%) patients had distant metastatic disease. Ninety seven (88.2%) underwent neoadjuvant chemotherapy and 67 (60.9%) underwent radiation therapy. Seventy five (68.2%) of the patients underwent mastectomy. The restricted mean time to recurrence was 9.01 years (standard error 3.162 months). ER positivity was associated with compromised recurrence-free survival. The overall survival rate was 0.962 at 10 years. Young patients diagnosed with breast cancer typically present with advanced breast imaging findings and undergo aggressive treatment. Recurrence often occurs >5 years from diagnosis, and ER positive subtypes are at increased risk for recurrence.     

中国成年人生活方式和心血管代谢因素与甲基化年龄加速的相关性分析

目的比较分析5种甲基化年龄加速指标与生活方式和心血管代谢因素间的相关性。方法基于中国慢性病前瞻性研究中有基线外周血全基因组甲基化检测数据的研究对象980人, 计算Horvath时钟、Hannum时钟、DNAm PhenoAge、GrimAge和Li时钟5种甲基化年龄。根据甲基化年龄对实足年龄回归的残差值计算甲基化年龄加速。研究的生活方式因素包括吸烟、饮酒、饮食习惯、体力活动、经BMI和腰围联合定义的体型。心血管代谢因素包括血压、血糖和TC。利用一般线性模型分析生活方式和心血管代谢因素与各甲基化年龄加速指标的相关性[β值(95%CI)]。结果 GrimAge加速指标与吸烟、饮酒、体力活动水平及BMI存在关联。与不吸烟、不饮酒或BMI为18.5～23.9 kg/m2 者相比, 吸烟者(每天吸烟1～14、15～24、≥25支者对应的β值依次为0.71(95%CI:0.57～0.86)、0.88(95%CI:0.73～1.03)、0.99(95%CI:0.81～1.18)、重度饮酒者[每日纯乙醇量≥60 g:0.33(95%CI:0.11～0.55)]、BMI<18.5 kg/m2者[0...     

Positive association between preoperative lymphocyte-to-monocyte ratio and risk of the status of positive surgical margins by prostate cancer: results in 497 consecutive patients treated only by radical prostatectomy

BackgroundPositive surgical margins (PSM) is one of the most important factors affecting the prognosis of prostate cancer (PCa) patients after radical prostatectomy (RP). Although some studies have found the preoperative systematic inflammation-based scores the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) can predict the incidence and prognosis of PCa, few studies have explored the predictive value of preoperative systematic inflammation-based scores on the PSMs for PCa patients after RP.MethodsFrom June 2014 to September 2020 a total of 497 patients underwent RP at our institution. Blood samples from all patients were collected within one week before surgery. Preoperative clinical characteristics including age, body mass index (BMI), prostate-specific antigen (PSA), and biopsy Gleason sum (BGS) were assessed. Postoperatively pathological specimens were assessed for pathological Gleason sum (PGS), pathological stage, and margin status.ResultsIn the multivariable analysis including preoperative variables, PSA and LMR were the independent predictive factors for PSM (OR: 2.817; 95% CI, 1.836–4.320, P<0.001; OR: 1.124; 95% CI, 1.018–1.240, P=0.021. Considering pre-, intra-, and postoperative variables, BGS, perineural invasion, seminal vesicle invasion (SVI), pathologic Gleason sum (PGS) combined, were associated with increased risk of PSM in the univariable analysis (P<0.001 for all variables). However, in the multivariable analysis, perineural invasion (OR: 2.672; 95% CI, 1.649–4.330; P<0.001), PGS (OR: 2.52; 95% CI, 1.556–4.082; P<0.001) were independent predictive factors for the incidence of PSM. Finally, LMR was shown to be an independent predictive factor (OR: 0.881; 95% CI, 0.779–0.996; P=0.043) for apical PSMs, with increasing LMR predicting the lower incidence of apex location. And we also found that LMR was an independent factor that predicts multifocal positive margins (OR: 1.179; 95% CI, 1.023–1.358; P=0.023).ConclusionsPreoperative LMR could be used as an independent predictor to predict the incidence of PSMs after RP. And Considering pre-, intra-, and postoperative variables, we also found that preoperative LMR could predict the occurrence of apical and multifocal PSMs.     

Anhedonia,positive affect dysregulation,and risk and maintenance of binge-eating disorder

Low positive affect has been identified as an antecedent of binge-eating episodes among individuals with binge-eating disorder (BED), yet positive affect has received far less attention in eating disorders research than its counterpart, negative affect. In this article, we argue that the low levels of positive affect which occur with anhedonia (i.e., loss of interest or pleasure in activities) may contribute to the onset and maintenance of BED. We introduce a theoretical model in which anhedonia increases the risk for BED through its interrelationships with dysregulated eating and weight gain, and we describe potential direct (e.g., reward-related processes) as well as indirect (e.g., influences on depressive symptoms and physical activity) pathways by which anhedonia may lead to adverse eating- and weight-related outcomes. We also propose a momentary maintenance model in which low positive affect and positive affect dysregulation occurring with anhedonia maintain binge eating directly and indirectly through maladaptive health behaviors, such as decreased physical activity, less healthy eating, and fewer social interactions, which in turn maintain anhedonia. We draw upon outside literature to present evidence that aligns with the proposed risk and maintenance models and conclude by outlining avenues for future research—including methodological/measurement, theoretical, and clinical research directions.     

老年认知功能缺损者二项必选数字记忆测验结果分析

目的：探讨认知功能缺损程度对二项必选数字记忆测验(简称二项测验)成绩的影响。方法：用简易智力状态量表和韦氏成人智力量表简式调查出38例认知功能缺损者(研究组)和19例无认知功能缺损者(对照组)，同时实施二项数字测验。结果：(1)研究组与对照组二项测验容易条目、困难条目、总分的得分差异均无显著性。(2)智商70-89者困难条目分及总分显著高于智商50-69及34-49者；各组间容易条目分的差异均无显著性。(3)二项测验的假阳性率随着认知功能缺损的加重而有增加趋势。结论：二项测验成绩在一定程度上受认知功能缺损的影响，尤其是严重认知功能减退者，应注意假阳性率的问题。     

一种适用于飞行教官的新型抗荷动作的表面肌电图评价

目的：提出适用于飞行教官的抗荷动作并对其抗荷效果进行表面肌电图评价。方法：选拔17~20岁受试者8名,试验设备采用AMST-HC-4E型载人离心机,根据初教机与高教机飞机性能及载荷特点,编制3.0G60s、4.0G50s、5.0G40s、6.0G30s及7.0G20s 共5条离心机加速度曲线,分别评价FT动作及HP动作抗荷效果,同时利用表面肌电技术观察不同载荷下两种抗荷动作训练前后肌肉用力变化及肌肉激活情况。结果：训练后,受试者使用FT动作与HP 动作时抗荷耐量均较训练前显著增加,与训练前相比,FT动作增加60.8%,HP 动作增加34.6%,FT+KH-X组增加50.5%,HP+KH-X增加51.7%,差异均有统计学差异(P>0.05);表面肌电测试结果显示,训练前后FT动作及HP动作的积分值(iEMG)均呈下降趋势,其中FT动作2.5G10s 载荷下右腓肠肌、3.0G60s载荷下左右腹直肌及右腓肠肌、5.0G40s载荷下左腹直肌训练前后的iEMG值下降差异有统计学差异(P<0.05)。FT动作与HP动作比较,3.0G60s载荷下,FT动作胫骨前肌iEMG显著高于HP动作(P<0.05),在4.0G50s+KHX及5.0G40s+KHX组,HP动作左腹直肌iEMG显著高于FT动作(P<0.05)。结论：本研究提出适用于飞行教官的一种新型抗荷动作且抗荷效果显著,值得推广。     

Therapeutic effects of radio frequency ablation in lung tumor treatment

Radiofrequencyablation(RFA)isarecentlyde-velopedsystemthatprovidesanewapproachforthetreatmentofpatientswithunresectablemalignanttu-mor.Aninsulatedneedleelectrodethatcontains10fineneedleswithinentersthetumortissueunderCTguidanceandthe10fineneedlesstretchasanumbrel-lacoveringanareaapproximately3.5cmindiameter,beforearadiofrequencygeneratortransmitshigh-en-ergyradiofrequencypulsesthroughthewiretothefineneedles.Theenergyreleasedattheneedlepointcantriggerionicagitationandfrictionalheattopro-ducea…     

BiPAP呼吸机正压给氧对增强肺癌放疗疗效的随机对照试验

目的　观察BiPAP呼吸机正压给氧对放射治疗 (简称放疗 )的影响 ,以探索提高中晚期肺癌治疗的新途径。方法　确诊的肺癌患者 30例随机分为联合治疗组和单纯放疗对照组 ,前者采用BiPAP呼吸机经鼻面罩正压通气给氧联合常规放疗 ,后者采用常规放疗 (6MV X)。观察通气前、后血氧分压 (PaO2 )、血氧饱和度 (SaO2 )变化和放疗前、后胸部X线片、血常规、细胞免疫功能变化 ,以及毒副反应发生情况。结果　①BiPAP呼吸机经鼻面罩正压通气给氧可明显提高PaO2 ,最高可增加 7.5kPa ,同时SaO2 均维持在 95 %以上。肺癌治疗有效率较对照组增加 6 .7个百分点。②治疗组放疗前后细胞免疫功能无明显变化 (P >0 .0 5 ) ,而对照组在放疗后淋巴细胞转化率、CD4及CD4/CD8比值明显降低 (P <0 .0 1 )。③治疗组仅 1例出现白细胞减少 (6 .7% ) ,而对照组有 5例出现白细胞明显降低 (33.3% ) ,需用升白药物才能继续完成放疗。胃肠道反应发生较对照组明显减少。结论　BiPAP呼吸机经鼻面罩正压通气给氧辅助肺癌放疗有一定疗效 ,可明显提高机体氧分压 ,对骨髓及细胞免疫功能有一定保护作用 ,亦能减少放疗所引起的毒副作用