Background: Neoadjuvant chemotherapy has gradually become an important means of breast cancer treatment; however, tumor regression following chemotherapy remains a concern. This study was conducted to investigate the effect of ultrasound-assisted carbon nanoparticle labeling in neoadjuvant chemotherapy for breast-conserving surgery in breast cancer.Methods: This was a prospective clinical trial study (clinical registration number: ChiCTR-OOC-15006844). Sixty-eight breast cancer patients confirmed by biopsy between July 2015 and January 2017 were randomly selected from the clinical data. Of these, 32 patients were screened for neoadjuvant chemotherapy, forming a consecutive, random series. An ultrasound-guided carbon nanotube was used to mark the original tumor, and sentinel lymph node biopsies were performed. After 4-6 cycles of standard neoadjuvant chemotherapy, 26 patients were selected for breast-conserving surgery. The feasibility and validity of carbon nanoparticle labeling were analyzed through the negative rate of incision margin, the volume of resected tumors, the detection rate of black-stained sentinel lymph nodes, the recurrence rate of ipsilateral breast, and postoperative survival.Results: In all, 32 patients underwent sentinel lymph node biopsy, 29 cases were detected (90.6%), the false-negative rate was 3.8% (1/26), and 0-4 sentinel lymph nodes (mean 1.8±1.1) were detected. A total of 26 patients underwent breast-conserving surgery, 5 underwent secondary excision, and 1 underwent subcutaneous adenectomy due to a positive margin. The minimum margin between the resected site and the infiltrated part was 1.0-2.1 cm (1.3±0.3 cm). The diameter of resected tumors ranged from 2.2 to 4.5 cm (3.1±0.6 cm). No recurrence or distant metastasis of ipsilateral breast tumors was observed during follow-up (the median follow-up time was 9 months).Conclusions: Ultrasound-assisted carbon nanoparticle labeling is effective for sentinel lymph node tracing before neoadjuvant chemotherapy and has a high detection rate for metastatic lymph nodes. During breastconserving surgery, it can determine the extent of tumor resection to achieve precision surgical treatment.
Background: We aimed to verify the feasibility of a novel temporary intestinal storage device (TISD) using a simple intestinal gunshot wound model. Methods: Ten female beagle dogs were fasted for 12 hours and anesthetized. An incision protector was inserted into a 10-cm abdominal incision. The small intestine was exposed to the body by natural drooping. An automatic rifle was used to shoot the intestine from a distance of 25 meters to introduce a simple intestinal gunshot wound. The three phases of first aid for war injuries were followed: Care Under Fire, Tactical Field Care, and Tactical Evacuation Care. For Tactical Field Care, a novel TISD was used to reconstruct the ruptured intestine, and necrotic intestinal tissue was stored. The abdominal cavity was temporarily closed, and the abdomen was opened for exploration 4 hours after surgery. Treatment time was observed during Care Under Fire, transfer time was observed from Tactical Field Care to Tactical Evacuation Care, rescue was observed during Tactical Evacuation Care, and the treatment time of each intestinal segment was measured. After 4 hours, intestinal vitality was observed, and the heart, liver, spleen, lung, kidney, stomach, normal intestine, and necrotic intestine were examined before and 4 hours after surgery by light microscopy. The broken ends of the intestine were connected to the intestinal reconstruction device before and 4 hours after surgery and were examined by transmission electron microscopy. Results: The processing time of Care Under Fire was 41.55 ± 10.46 seconds, which is shorter than the maximum time limit of the battlefield first aid principle. Transit time from Care Under Fire to Tactical Field Care transit was 60.78 ± 15.95 seconds, which is shorter than the battlefield first aid principle. The treatment time of Tactical Field Care was 29.75 ± 5.13 minutes, and the reconstruction time of each intestinal segment was 4.44 ± 0.31 minutes. One dog died of anesthetic overdose, two died of splenic bleeding, and the rest completed all phases. The abdominal cavity was explored 4 hours after surgery, and the TISD was positioned. Intestinal tract reconstruction was normal, and no obvious necrosis was observed. Necrotic intestine had the same vitality as before storage. With light microscopy, the heart, liver, spleen, lung, kidney, and stomach showed no obvious necrosis, inflammatory cell infiltration, or necrosis of normal intestine before and after surgery. Before and 4 hours after surgery, intestinal necrosis involved local necrosis of villi and tissues, and marked inflammatory cell infiltration. Transmission electron microscopy showed that the villi of the intestinal stump connected to the TISD before surgery were intact, and no obvious necrosis was observed. The villi of the intestinal stump were moderately damaged after surgery, and focal necrosis was observed. Conclusions: The novel TISD can be used in the emergency treatment of simple small intestine gunshot wounds in beagle dogs and can prevent further deterioration after intestinal injury. Background: We aimed to verify the feasibility of a novel temporary intestinal storage device (TISD) using a simple intestinal gunshot wound model.
Background Breast cancer (BRCA) is the most common malignancy with high morbidity and mortality in women, and transcription factor (TF) is closely related to the occurrence and development of BRCA. This study was designed to identify a prognostic gene signature based on TF family to reveal immune characteristics and prognostic survival of BRCA. Methods In this study, RNA-sequence with corresponding clinical data were obtained from The Cancer Genome Atlas (TCGA) and GSE42568. Prognostic differentially expressed transcription factor family genes (TFDEGs) were screened to construct a risk score model, after which BRCA patients were stratified into low-risk and high-risk groups based on their corresponding risk scores. Kaplan–Meier (KM) analysis was applied to evaluate the prognostic implication of risk score model, and a nomogram model was developed and validated with the TCGA and GSE20685. Furthermore, the GSEA revealed pathological processes and signaling pathways enriched in the low-risk and high-risk groups. Finally, analyses regarding levels of immune infiltration, immune checkpoints and chemotactic factors were all completed to investigate the correlation between the risk score and tumor immune microenvironment (TIME). Results A prognostic 9-gene signature based on TFDEGs was selected to establish a risk score model. According to KM analyses, high-risk group witnessed a significantly worse overall survival (OS) than low-risk group in both TCGA-BRCA and GSE20685. Furthermore, the nomogram model proved great possibility in predicting the OS of BRCA patients. As indicted in GSEA analysis, tumor-associated pathological processes and pathways were relatively enriched in high-risk group, and the risk score was negatively correlated with ESTIMATE score, infiltration levels of CD4+ and CD8+T cells, as well as expression levels of immune checkpoints and chemotactic factors. Conclusions The prognostic model based on TFDEGs could distinguish as a novel biomarker for predicting prognosis of BRCA patients; in addition, it may also be utilized to identify potential benefit population from immunotherapy in different TIME and predict potential drug targets.
IntroductionCellular senescence is a cellular response to stress, including the activation of oncogenes, and is characterized by irreversible proliferation arrest. Restricted studies have provided a relationship between cellular senescence and immunotherapy for esophageal cancer.MethodsIn the present study, we obtained clinical sample of colon cancer from the TCGA database and cellular senescence-related genes from MSigDB and Genecard datasets. Cellular senescence-related prognostic genes were identified by WGCNA, COX, and lasso regression analysis, and a cellular senescence-related risk score (CSRS) was calculated. We constructed a prognostic model based on CSRS. Validation was performed with an independent cohort that GSE53625. Three scoring systems for immuno-infiltration analysis were performed, namely ssGSEA analysis, ESTIMATE scores and TIDE scores.ResultFive cellular senescence-related genes, including H3C1, IGFBP1, MT1E, SOX5 and CDHR4 and used to calculate risk score. Multivariate regression analysis using cox regression model showed that cellular senescence-related risk scores (HR=2.440, 95% CI=1.154-5.159, p=0.019) and pathological stage (HR=2.423, 95% CI=1.119-5.249, p=0.025) were associated with overall survival (OS). The nomogram model predicts better clinical benefit than the American Joint Committee on Cancer (AJCC) staging for prognosis of patients with esophageal cancer with a five-year AUC of 0.946. Patients with high CSRS had a poor prognosis (HR=2.93, 95%CI=1.74-4.94, p<0.001). We observed differences in the distribution of CSRS in different pathological staging and therefore performed a subgroup survival analysis finding that assessment of prognosis by CSRS independent of pathological staging. Comprehensive immune infiltration analysis and functional enrichment analysis suggested that patients with high CSRS may develop immunotherapy resistance through mechanisms of deacetylation and methylation.DiscussionIn summary, our study suggested that CSRS is a prognostic risk factor for esophageal cancer. Patients with high CSRS may have worse immunotherapy outcomes.
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