Clinicopathological features,psychological status,and prognosis of 33 patients with occult breast cancer

BACKGROUND Occult breast cancer(OBC)has traditionally been considered to be a carcinoma of unknown primary origin with a favorable prognosis and can be treated as stage II-III breast cancer.Due to the small number of cases and limited clinical experience,treatments vary greatly around the world and no standardized treatment has yet been established.AIM To investigate the clinicopathological features,psychological status and prognostic features of patients with OBC.METHODS The clinicopathological data of 33 OBC patients diagnosed and treated in the Affiliated Hospital of Xuzhou Medical University and Xuzhou Central Hospital from November 2015 to November 2022 were retrospectively analyzed.The psychological status of OBC patients was evaluated by the Self-rating Anxiety Scale and Self-rating Depression Scale.Patients’emotions,stress perception and psychological resilience were evaluated by the Positive and Negative Affect Schedule,the Chinese Perceived Stress Scale,and the Connor-Davidson Resilience Scale(CD-RISC),respectively.Patient survival was calculated using the Kaplan-Meier method,and survival curves were plotted for analysis with the log-rank test.Univariate and multivariate survival analyses were performed using the Cox regression model.RESULTS The 33 OBC patients included 32 females and 1 male.Of the 33 patients,30(91%)had axillary tumors,3(9%)had a neck mass as the primary symptom;18(54.5%)had estrogen receptor-positive tumors,17(51.5%)had progesterone receptor-positive tumors,and 18(54.5%)had Her-2-positive tumors;24(72.7%)received surgical treatment,including 18 patients who underwent modified radical mastectomy,1 patient who underwent breast-conserving surgery plus axillary lymph node dissection(ALND),and 5 patients who underwent ALND alone;12 patients received preoperative neoadjuvant therapy.All 30 patients developed anxiety and depression,with low positive affect scores and high negative affect scores,accompanied by a high stress level and poor psychological resilience.There were no differences in the psychological status of patients according to age,body mass index,or menopausal status.The overall survival and disease-free survival(DFS)of all the patients were 83.3%and 55.7%,respectively.Univariate analysis demonstrated that the initial tumor site(P=0.021)and node stage(P=0.020)were factors that may affect patient prognosis.The 5-year DFS rate of OBC patients who received radiotherapy was greater(P<0.001),while the use of different surgical methods(P=0.687)had no statistically significant effect on patient outcomes.Multivariate analysis revealed that radiotherapy(P=0.031)was an independent prognostic factor.Receiving radiotherapy had a significant effect on the CD-RISC score(P=0.02).CONCLUSION OBC is a rare breast disease whose diagnosis and treatment are currently controversial.There was no significant difference in the efficacy of other less invasive surgical procedures compared to those of modified radical mastectomy.In addition,radiotherapy can significantly improve patient outcomes.We should pay attention to the psychological state of patients while they receive antitumor therapy.

Carbon and oxygen isotopic constraints on paleoclimate and paleoelevation of the southwestern Qaidam basin, northern Tibetan Plateau

We investigate the growth of the northern Tibetan Plateau and associated climate change by applying oxygen and carbon isotopic compositions in Cenozoic strata in the southwestern Qaidam basin. The X-ray diffraction and isotopic studies reveal that the carbonate minerals are mainly authigenic and they do not preserve any evidence for detrital carbonate and diagenesis. The isotope data show large fluctuations in the δ^(18)O and δ^(13)C values in the middle-late Eocene, indicating relatively warm and seasonal dry climate.The positive correlation of the δ^(18)O and δ^(13)C values in the Oligocene and the positive shift of the δ^(13)C values from the Eocene to Oligocene suggest that the climate changed to arid in the Oligocene. However,the δ^(18) values show negative shift, which is closely related to the global cooling event. During the Miocene, the δ^(13)C values vary between-2‰ and-4‰, whereas the δ^(18)O values show continuous negative shift. The mean δ^(18) values decrease from-8.5‰, in the early Miocene to-10.0‰, in the late Miocene. The stable isotope-based paleoaltimetry results suggest that the elevation of the southwestern Qaidam basin was approximately 1500 m in the middle-late Eocene and Oligocene. Subsequently, during Miocene the crustal uplift process started and the elevation reached approximately 2000 m in the early Miocene and 2500 m in the late Miocene, which suggests large-scale growth of the northern Tibet Plateau during the Miocene.

易筋经联合耐力运动对冠心病患者心肺功能和生活质量的影响

目的观察易筋经联合耐力运动对冠心病患者心肺功能和生活质量的影响。方法 90例冠心病患者通过随机数字表法分为常规治疗组、功率车训练组、易筋经和功率车联合训练(易筋经训练)组,各30例。常规治疗组只进行常规治疗,功率车训练组在常规治疗的基础上进行功率车训练,易筋经训练组在进行常规治疗的同时给予易筋经联合耐力运动训练,疗程12周。结果治疗12周后,功率车训练组和易筋经训练组的无氧阈(anaerobic threshold,AT)、峰值功率(peak power,PP)、峰值氧脉搏(peak oxygen pulse,POP)、用力肺活量(forced vital capacity,FVC)、第1秒用力呼气量(forced expiratory volume in first second,FEV1)、最大通气量(maximal voluntory ventilation,MVV)以及健康测量量表(the MOS item short from health survey, SF-36)中的总体健康(General Health, GH)、社会功能(Social Functioning, SF)、精神健康(Mental Health, MH)显著高于常规治疗组(P < 0.05),二氧化碳通气当量斜率(ventilation relative to carbon dioxide production,VE/VCO2)显著低于常规治疗组(P < 0.05);并且易筋经训练组在改善POP、VE/VCO2、MVV以及GH和MH显著优于功率车训练组(P < 0.05)。结论易筋经联合耐力运动能明显改善冠心病患者的心肺功能,提高其运动能力,改善其生活质量,最终提高冠心病患者的幸福指数。

Intravoxel incoherent motion diffusion-weighted magnetic resonance imaging for predicting histological grade of hepatocellular carcinoma:Comparison with conventional diffusion-weighted imaging

AIM To compare intravoxel incoherent motion(IVIM)-derived parameters with conventional diffusion-weighted imaging(DWI) parameters in predicting the histological grade of hepatocellular carcinoma(h CC) and to evaluate the correlation between the parameters and the histological grades.METHODS A retrospective study was performed. Sixty-two patients with surgically confirmed h CCs underwent diffusion-weighted magnetic resonance imaging with twelve b values(10-1200 s/mm^2). The apparent diffusion coefficient(ADC), pure diffusion coefficient(D), pseudo-diffusion coefficient(D*), and perfusion fraction(f) were calculated by two radiologists. The IVIM and conventional DWI parameters were compared among the different grades by using analysis of variance(ANOVA) and the Kruskal-Wallis test. Receiver operating characteristic(ROC) analysis was performed to evaluate the diagnostic efficiency of distinguishing between low-grade(grade 1, G1) and high-grade(grades 2 and 3, G2 and G3) hC C. The correlation between the parameters and the histological grades was assessed by using the Spearman correlation test. Bland-Altman analysis was used to evaluate the reproducibility of the two radiologists' measurements.RESULTS The differences in the ADC and D values among the groups with G1, G2, and G3 histological grades of HCCs were statistically significant(P < 0.001). The D* and f values had no significant differences among the different histological grades of h CC(P > 0.05). The ROC analyses demonstrated that the D and ADC values had better diagnostic performance in differentiating the low-grade h CC from the high-grade h CC, with areas under the curve(AUCs) of 0.909 and 0.843, respectively, measured by radiologist 1 and of 0.911 and 0.852, respectively, measured by radiologist 2. The following significant correlations were obtained between the ADC, D, and D~* values and the histological grades: r =-0.619(P < 0.001), r =-0.628(P < 0.001), and r =-0.299(P = 0.018), respectively, as measured by radiologist 1; r =-0.622(P < 0.001), r =-0.633(P < 0.001), and r =-0.303(P = 0.017), respectively, as measured by radiologist 2. The intra-class correlation coefficient(ICC) values between the two observers were 0.996 for ADC, 0.997 for D, 0.996 for D*, and 0.992 for f values, which indicated excellent interobserver agreement in the measurements between the two observers.CONCLUSION The IVIM-derived D and ADC values show better diagnostic performance in differentiating high-grade hC C from low-grade hC C, and there is a moderate to good correlation between the ADC and D values and the histological grades.

Advances in biodegradable nanomaterials for photothermal therapy of cancer

Photothermal cancer therapy is an alternative to chemotherapy, radiotherapy, and surgery. With the development of nanophotothermal agents, this therapy holds immense potential in clinical translation. However, the toxicity issues derived from the fact that nanomaterials are trapped and retained in the reticuloendothelial systems limit their biomedical application.Developing biodegradable photothermal agents is the most practical route to address these concerns. In addition to the physicochemical properties of nanomaterials, various internal and external stimuli play key roles on nanomaterials uptake,transport, and clearance. In this review, we summarized novel nanoplatforms for photothermal therapy; these nanoplatforms can elicit stimuli-triggered degradation. We focused on the recent innovative designs endowed with biodegradable photothermal agents under different stimuli, including enzyme, p H, and near-infrared(NIR) laser.

Cavitation performance of high-speed centrifugal pump with annular jet and inducer at different temperatures and void fractions

The cavitation is very common in a centrifugal pump,especially when the speed is very high,and it seriously influences the centrifugal pump performance.In this investigation,the RNG k-ε turbulence model and the cavitation model with consideration of the mass transferring are first used to simulate the cavitation performance of the high-speed centrifugal pump without taking any measure for improving the pump cavitation performance.The calculation results reveal that a number of bubbles appear in the centrifugal pump flow channel,and the head as well as the flow rate of the high-speed centrifugal pump are far from its design condition.The cavitation performance can be improved effectively by arranging a variable pitch inducer and adopting an annular nozzle scheme.The flow field analysis of the pump is conducted to obtain the suitable working temperature distribution at different void fractions.On one hand,with the same void fraction,the head of the centrifugal pump drops slowly with the increase of temperature.However,when the temperature exceeds 90°C,the head of the pump drops rapidly.On the other hand,at the constant temperature,the higher the void fraction,the worse the cavitation performance.This research conducted under different temperatures and void fractions provides some guidance for designing an effective high-speed centrifugal pump.

Generation and manipulation of skyrmions and other topological spin structures with rare metals

Skyrmions are nano-scale quasi-particles with topological protection,which have potential applications in next-generation spintronics-based information storage.Numerous papers have been published to review various aspects of skyrmions,including physics,materials and applications.However,no review paper has focused on rare metals which play important roles in nucleating and manipulating skyrmions and other topological states.In this paper,various roles of rare metals have been classified and summarized,which can tune Curie temperature(TC),Dzyaloshinskii-Moriya interaction(DMI),magnetocrystalline anisotropy,Ruderman-Kittel-Kasuya-Yosida(RKKY)interaction and four-spin interaction so as to trigger the generation of skyrmions and other topological spin structures.The materials covered include typical B20 crystals,various layered systems with interfacial DMI,frustrated materials,antiferromagnets,ferrimagnets,twodimensional(2D)materials,etc.In addition,the rare-earth(RE)permanent magnets can provide an energy barrier and enrich the dynamic behaviors of skyrmions,which has also been reviewed.

Effective Stacking Fault Energy in Face-Centered Cubic Metals

As a typical configuration in plastic deformations, dislocation arrays possess a large variation of the separation of the partial dislocation pairs in face-centered cubic（fcc） metals. This can be manifested conveniently by an effective stacking fault energy（SFE）. The effective SFE of dislocation arrays is described within the elastic theory of dislocations and verified by atomistic simulations. The atomistic modeling results reveal that the general formulae of the effective SFE can give a reasonably satisfactory prediction for all dislocation types, especially for edge dislocation arrays. Furthermore, the predicted variation of the effective SFE is consistent with several previous experiments, in which the measured SFE is not definite, changing with dislocation density. Our approach could provide better understandings of cross-slip and the competition between slip and twinning during plastic deformations in fcc metals.