Staphylococcus aureus colonization in the nares of patients undergoing elective orthopedic surgery increases the potential risk of surgical site infections. Methicillin-resistant S. aureus (MRSA) has gained recognition as a pathogen that is no longer only just a hospital-acquired pathogen. Patients positive for MRSA are associated with higher rates of morbidity and mortality following infection. MRSA is commonly found in the nares, and methicillin-sensitive S. aureus (MSSA) is even more prevalent. Recently, studies have determined that screening for this pathogen prior to surgery and diminishing staphylococcal infections at the surgical site will dramatically reduce surgical site infections. A nasal mupirocin treatment is shown to significantly reduce the colonization of the pathogen. However, this treatment is expensive and is currently not available in China. Thus, in this study, we first sought to determine the prevalence of MSSA/MSRA in patients undergoing elective orthopedic surgery in northern China, and then, we treated the positive patients with a nasal povidone-iodine swab. Here, we demonstrate a successful reduction in the colonization of S. aureus. We propose that this treatment could serve as a cost-effective means of eradicating this pathogen in patients undergoing elective orthopedic surgery, which might reduce the rate of surgical site infections.

et al. Displacement of the lumpectomy cavity defined by surgical clips and seroma based on 4D-CT scan for external-beam partial breast irradiation after breast-conserving surgery: a comparative study. Br J Radiol 2013;86:20130416. FULL PAPER Displacement of the lumpectomy cavity defined by surgical clips and seroma based on 4D-CT scan for external-beam partial breast irradiation after breast-conserving surgery: a comparative study Objective: To compare the displacements of the lumpectomy cavity delineated by the surgical clips and the seroma based on four-dimensional CT (4D-CT) for external-beam partial breast irradiation (EB-PBI) after breast-conserving surgery (BCS). Methods: 14 breast cancer patients after BCS were recruited for EB-PBI and undertook 4D-CT simulation.On the 10 sets of the 4D-CT images, all the surgical clips in the cavity were delineated. The gross tumour volume (GTV) formed by the clips, the seroma, and both the clips and the seroma were defined as GTV c , GTV s and GTV c1s , respectively. The displacements of the centre of mass (COM) of the clips, GTV c , GTV s , GTV c1s and the selected clips in the three-dimensional (3D) directions were recorded and compared.Results: In the left-right, anterior-posterior and superiorinferior directions, the displacements were 2.20, 1.80 and 2.70 mm for the clip COM; 0.90, 1.05 and 1.20 mm for GTV c ; 0.80, 1.05 and 0.80 mm for GTV s ; and 0.90, 1.20 and 1.40 mm for GTV c1s , respectively. In the 3D directions, the displacements of the clip COM were greater than the GTV c , GTV s , GTV c1s , and the displacements of the clip COM, GTV c1s , GTV c and GTV s were significantly greater than the displacements of the selected clips (p,0.05). Conclusion:The displacements of the clip COM were greater than that of the GTV c , GTV s , GTV c1s and the four selected clips. The optimal internal target volume should be defined based on the boundary displacements. Advances in knowledge: When the GTV was delineated using the clips and/or the seroma, there was displacement difference between the lumpectomy cavity centre and the boundary for the EB-PBI. The optimal internal target volume should be defined based on the boundary displacements of the lumpectomy cavity.Previous studies have reported that approximately 70-80% of the in-breast tumour recurrences occurred in the vicinity of the tumour bed (TB) and that the absolute risk of ipsilateral breast recurrence away from the primary tumour site is approximately 1.5-3.5% [1][2][3][4]. Thus, for early-stage breast cancer patients after breast-conserving surgery (BCS), partial breast irradiation (PBI), treating only the lumpectomy cavity with a suitable margin, may achieve a similar local control rate and an overall survival rate to whole-breast irradiation treating the whole breast. Externalbeam partial breast irradiation (EB-PBI) is an important approach in PBI, and clinical research has demonstrated that EB-PBI can achieve excellent results after strict patient selection and accurate target volume delineation [5,6].Accur...

Cell-free DNA integrity (cfDI) is a promising diagnostic and prognostic biomarker in breast cancer. However, no specific study has evaluated the diagnostic ability of cfDI in patients with no distant metastasis breast cancer (no-MBC) and benign breast tumor (BBT) to date. We assessed the plasma cfDI of 84 patients with no-MBC and 30 patients with BBT using quantitative PCR and compared it with circulating tumor cells (CTCs) and carbohydrate antigen 153 (CA153). The no-MBC group had significantly lower mean cfDI (0.58) than the BBT group (0.74, p = 0.004). Subgroup analysis showed that decreased cfDI seem to be associated with risk factors such as age 14% (mean cfDI = 0.57), tumor size > 2 cm (mean cfDI = 0.58), and positive lymph node status (mean cfDI = 0.56), but had no statistical significance. McNemar's test suggested that cfDI had stronger diagnostic power than CTCs, cfDNA concentration, or CA153 (p < 0.001). Spearman's rho showed that the correlation coefficient between cfDI and CTCs was 0.278 (p = 0.04) in the no-MBC group. Receiver operating characteristic curve analysis also suggested that cfDI was superior to CTCs or CA153. Combined with CTCs, cfDI reduced the false positive rate from 50% to 10.71% and increased the area under the curve value from 0.66 to 0.68. Our results suggest that cfDI is a potential diagnostic biomarker of no-MBC. Using cfDI and CTCs as a combined diagnostic tool for no-MBC could improve diagnostic sensitivity and specificity but more samples will be needed.

1003 (71.6%) patients were non-squamous cell carcinoma, and 397 (28.4%) were squamous cell carcinoma. The number of patients with pT1, pT2, and pT3 were 174 (12.4%), 995 (71.1%), and 231 (16.5%), respectively. 899 patients (64.2%) received adjuvant chemotherapy, and 334 patients (23.9%) underwent postoperative radiotherapy. The median follow-up time was 38.7 months. The 1, 3 and 5-year OS rates were 92.9%, 66.4% and 52.1%, respectively. The 1, 3 and 5-year cumulative incidence of BM were 6%, 13.9% and 22.2%, respectively. In univariate analysis, patients ≤ 60 years old, non-smokers, non-squamous cell carcinoma, lymph node metastases number≥ 4, lymph node metastases rate > 30%, and adjuvant chemotherapy were more likely to develop BM. In multivariate analysis, non-squamous cell carcinoma (HR:2.789, 95༅CI:1.779-4.372; P < 0.001), lymph node metastasis number≥4 (HR:1.448, 95༅CI:1.042-2.011;P = 0.027) and adjuvant chemotherapy (HR:2.168, 95༅CI:1.507-3.120;P < 0.001) were independent risk factors of BM. Conclusion: Non-squamous cell carcinoma, lymph node metastasis number ≥ 4 and adjuvant chemotherapy are the high-risk factors of BM in patients with pIIIA-N2 NSCLC after complete resection. These groups of patients may benefit from PCI and can be enrolled in the further study.

Introduction: Next-generation sequencing (NGS)-based circulating tumor DNA (ctDNA) detection is a promising monitoring tool for lymphoid malignancies. Studies for T cell lymphoma are limited. Objective: To explored whether next-generation sequencing (NGS)based circulating tumor DNA (ctDNA) detection is applicable to T cell lymphoma and assessed its performance in clinical settings.

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