Objective. The purpose of this study was to evaluate the contrast-enhanced ultrasonographic (CEUS) characteristics of metastatic lymph nodes (LNs) and to determine the correlation of CEUS parameters with the tumor aggressiveness in patients with breast cancer. Methods. Real-time gray scale CEUS of axillary LNs was preoperatively performed in 51 consecutive patients with breast carcinoma who were scheduled for axillary lymph node dissection. The CEUS characteristics assessed by a direct visualization method and quantification software were compared with pathologic findings. Expression of human epidermal growth factor receptor 2 (HER-2/neu) in the primary tumor was detected by immunohistochemical analysis. Correlation analysis of CEUS parameters with HER-2/neu expression and the LN stage was performed. Results. Of the LNs examined, 27 were metastatic, and 25 were diagnosed as reactive hyperplasia. Lymph nodes with metastasis were characterized by centripetal progress (66.7%) and a heterogeneous pattern (55.6%) or no or scarce perfusion (25.9%). However, LNs with nonmetastases were characterized by with centrifugal enhancement (56.0%) and a homogeneous pattern (80.0%). The difference between the hyperintense and hypointense regions was higher in metastatic LNs than nonmetastatic ones (P < .001). No significant differences were found in the arrival time, time to peak intensity, and peak intensity between the two groups. A histopathologic diagnosis could be predicted with sensitivity, specificity, and accuracy of 92.6%, 76.0%, and 84.6% respectively, by a standardized difference between maximum and minimum signal intensity (SI max -SI min ) value of 28. Human epidermal growth factor receptor 2 expression and the LN histopathologic stage were significantly associated with the SI max -SI min . In metastatic LNs, the relationship between the diagnostic sensitivity of CEUS and the transverse diameter of LNs remained statistically significant (P < .05). Conclusions. Noninvasive CEUS can play a role in discriminating metastatic from nonmetastatic LNs and predicting the aggressiveness in patients with breast cancer. Key words: breast neoplasm; contrast-enhanced ultrasonography; human epidermal growth factor receptor 2; lymph node metastasis; reactive hyperplasia lymph node. Abbreviations ALND, axillary lymph node dissection; AT, arrival time; CEUS, contrast-enhanced ultrasonography; HER-2/neu, human epidermal growth factor receptor 2; LN, lymph node; MRI, magnetic resonance imaging; PI, peak signal intensity; PT, time to peak intensity; ROC, receiver operating characteristic; SI max -SI min , difference between maximum and minimum signal intensity he detection of metastasis in lymph nodes (LNs) is critical for tumor staging and preoperative planning in patients with breast cancer. Because of the lack of accurate noninvasive methods for diagnosing LN metastasis, axillary lymph node dissection (ALND) is performed routinely in cases of invasive breast cancer.1 However, ALND is a costly procedure associated with various side ef...

Angiogenesis is an essential process for tumor development and metastasis, therefore inhibition of tumor angiogenesis has become a promising strategy for anticancer treatments. Patrinia scabiosaefolia, a well-known Oriental folk medicine, has been shown to be effective in the clinical treatment of gastrointestinal cancers. However, the precise mechanism of its tumoricidal activity remains largely unknown. Using a colorectal cancer (CRC) mouse xenograft model, the human colon carcinoma cell line HT-29 and human umbilical vein endothelial cells (HUVECs), in the present study we evaluated the effects of an ethanol extract of Patrinia scabiosaefolia (EEPS) on tumor angiogenesis in vivo and in vitro, and investigated the underlying molecular mechanisms. We found that EEPS treatment significantly reduced the tumor volume in CRC mice and decreased the intratumoral microvessel density in tumor tissues. In addition, EEPS inhibited several key processes of angiogenesis, including the proliferation, migration and tube formation of HUVECs. Moreover, EEPS treatment suppressed the expression of VEGF-A in CRC tumors and HT-29 cells. Collectively, our data suggest that Patrinia scabiosaefolia inhibits CRC growth likely via suppression of tumor angiogenesis.

Objective. The adverse effects of 5-fluorouracil (5-FU) are well recognized. Fuzheng-Yiliu granule (FYG) is capable of enhancing the immune function and suppressing tumor growth. In the present study, the authors evaluated if FYG could synergize with low-dose 5-FU in inhibiting tumor growth. Methods. Hepatoma 22 (H22) tumor-bearing mice were treated with FYG (18 g/kg, ig), 5-FU (10 mg/kg, ip), or 5-FU plus FYG for 5 days. The relative tumor proliferation rates, tumor weight and apoptosis of tumor tissue were measured. White blood cell (WBC) and lymphocyte (LY) were counted. Interleukin-2 (IL-2) and tumor necrosis factor (TNF-a) in the serum were measured. Results. FYG alone had antitumor effect. Combination of 5-FU and FYG produced a more potent antitumor effect and caused more marked apoptosis in tumor tissue (compared with vehicle, P < 0.01; compared with 5-FU or FYG, P < 0.05). Mice treated with 5-FU plus FYG had higher thymus index (P < 0.05) compared with the vehicle group. The numbers of both WBC and LY were decreased by 5-FU (compared with vehicle, P < 0.01), which was significantly reversed after FYG was administered (5-FU + FYG vs 5-FU, P < 0.01 and P < 0.05). Mice receiving FYG alone or FYG plus 5-FU had higher serum levels of TNF-a (P <0.01) compared with the vehicle. Conclusions. Traditional Chinese medical herbs capable of strengthening the body's vital energy have great potential to be used as an adjuvant therapy for cancer patients who cannot tolerate the adverse effects of chemotherapy.

Stroke has become a major public health concern globally. 1 The burden of stroke has increased significantly worldwide in the past two decades. The incidence of stroke has decreased in developed countries, by contrast, it has increased significantly in developing countries. 2 In China, stroke has become the first leading cause of death, and it is the most prominent factor for disability-adjusted life-years lost. 3 Epidemiological studies of sex disparity in the prevalence, incidence, and mortality of stroke and its risk factors have been conducted in Western countries; 4-8 however, no studies have focused on sex differences in the risk factors for stroke in China. With stroke becoming a great public health issue, findings on sex disparity in stroke risk factors among the Chinese adults are urgently needed to facilitate future personalized healthcare management policy and planning. Thus, we aimed to examine sex differences in the risk factors for stroke based on a nationally representative population-based sample of middle-aged and older Chinese populations.The China National Stroke Screening and Prevention Project (CNSSPP) was a key national action on stroke prevention and control launched in 2011 by the Chinese government.The rationale, design, and methods of the CNSSPP have previously been described in detail. 9Our study was based on the data from the CNSSPP in 30 provinces in Mainland China conducted between October 1 st 2014 and November 30 th 2015. Briefly, a stratified, multistage random sampling method was used to obtain a nationally representative sample of the general Chinese population aged 40 years or older.Socio-demographic characteristics, stroke history, family history of stroke, medical history, and status of risk factors were collected though trained healthcare workers with a standardized 4 questionnaire. Physical examinations included the assessment of height, weight, and blood pressure (BP) and an electrocardiogram. Laboratory examinations included the measurements of serum lipids (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides) and fasting plasma glucose.The associations between sex and stroke related risk factors, including stroke history, hypertension, diabetes mellitus (DM), hyperlipidemia, atrial fibrillation (AF), smoking, overweight or obesity, and physical inactivity, were estimated using multivariable logistic regression analysis, respectively. We performed analyses by using SAS version 9.3, and all tests were 2-sided with a significance level of 0.05.A total of 726,451 respondents (53.27% women) with a mean age of 57.23±11.41 years were investigated in this study. The relatively young mean age among people aged 40 and over in our sample was due to the population structure in China (Figure 1). The age-standardized prevalence rate of stroke was 2.11%. The age-standardized prevalence of stroke was markedly higher in males compared to females (2.30% versus 1.94%).The sex differences in risk factors associated with stroke are show...