Breast Cancer Subtypes and Survival in Chinese Women with Operable Primary Breast Cancer

Objective： To investigate the associations between the different breast cancer subtypes and survival in Chinese women with operable primary breast cancer. Methods： A total of 1538 Chinese women with operable primary breast cancer were analyzed in this study, the median follow-up was 77 months. Estrogen receptor （ER）, progesterone receptor （PR）, and HER2 status were available for these patients. Results： Luminal A （ER＋ and/or PR＋, HER2-） had a favorable disease-free survival （DFS） and overall survival （OS） compared with other subtypes in the entire cohort. Using the luminal A as a reference, among the patients with lymph node positive disease, HER2＋ （ER-, PR-, HER2＋） had the worst DFS （hazard ratio, HR=1.80, 95% CI 1.11 to 2.91, P=0.017） and luminal B （ER＋ and/or PR＋, HER2＋） had the worst OS （HR=2.27, 95% CI 1.50 to 3.45, P0.001）; among the patients with lymph node negative disease, triple-negative （ER-, PR-, HER2-） had the worst DFS （HR=2.21, 95% CI 1.43 to 3.41, P0.001）, whereas no significant difference in DFS between HER2＋ and luminal B or luminal A was observed. Conclusion： As compared with luminal A, luminal B and HER2＋ have the worst survival in patients with lymph node positive disease, but this is not the case in patients with lymph node negative disease; triple-negative subtype has a worse survival in both lymph node positive and lymph node negative patients.

Hemichorea due to ipsilateral thalamic infarction: A case report

BACKGROUND Hemichorea usually results from vascular lesions of the basal ganglia.Most often,the lesion is contralateral to the affected limb but rarely,it may be ipsilateral.The pathophysiology of ipsilateral hemichorea is still poorly understood.We review the literature on hemichorea due to ipsilateral cerebral infarction and explore possible mechanisms for its occurrence.CASE SUMMARY A 72-year-old woman presented with complaints of involuntary movements of the muscles of the left side of the face and mild weakness of the right limbs.Her symptoms had started suddenly 1 d earlier.After admission to the hospital,the involuntary movements spread to involve the left limbs also.Magnetic resonance imaging revealed a left thalamic infarction.The patient’s hemichorea subsided after treatment with haloperidol(2 mg per time,3 times/d)for 3 d;the hemiparesis resolved with rehabilitation physiotherapy.She is presently symptom free and on treatment for prevention of secondary stroke.We review the literature on the occurrence of ipsilateral hemichorea following thalamic infarction and discuss the possible pathomechanisms of this unusual presentation.CONCLUSION Ipsilateral hemichorea following a thalamic stroke is rare but it can be explained by structure of the extrapyramidal system.The thalamus is a relay station that exerts a bilateral control of motor function.

Research on the Magnetic Field of NGC 7793 P13 and Other Confirmed Pulsating Ultraluminous X-Ray Sources

A pulsating ultraluminous X-ray source(PULX)is a new kind of pulsar(PSR)whose characteristics are different from all known neutron stars.The magnetic field of PULX is suspected to be the main reason to support its supper Eddington luminosity of PULX.NGC 7793 P13,which is the second confirmed PULX,can be easily studied due to its nearby position and isolation from other sources in its host galaxy.In this paper,we calculate its magnetic field to be∼1.0×10^(12) G based on the continued observations from 2016 to 2020.The magnetic field evolution of NGC 7793 P13 is analyzed,which shows that the source has spent about 10^(4) yr for the field decaying from the simulated initial strength 4.0×10^(14) G to the present value.In case of an assumed constant accretion and the limitation of the companion mass,it will be a recycled PSR whose magnetic field is ∼10^(9) G and spin period is a few hundred milliseconds.We estimate the field strength of the other confirmed PULXs and find main range is 10^(13)-10^(14) G.Their positions of the magnetic field and spin period are around or below the magnetars.This is because these PULXs are in the binary systems and are with the spin-up rate that are 2-3 orders higher than the normal binary pulsars.We suggest that PULXs are the accreting magnetars whose multi-pole strong magnetic field can support the supper Eddington luminosity.They would be helpful for studying the evolution of the magnetars,the formation of the binary PSRs above the Eddington spin-up line,and the millisecond PSRs with the magnetic field stronger than ∼10^(9) G.

Understanding the X-ray spectrum of anomalous X-ray pulsars and soft gamma-ray repeaters

Hard X-rays above 10 keV are detected from several anomalous X-ray pul- sars （AXPs） and soft gamma-ray repeaters （SGRs）, and different models have been proposed to explain the physical origin within the frame of either a magnetar model or a fallback disk system. Using data from Suzaku and INTEGRAL, we study the soft and hard X-ray spectra of four AXPs/SGRs： 1RXS J 170849-400910, 1E 1547.0- 5408, SGR 1806-20 and SGR 0501＋4516. It is found that the spectra could be well reproduced by the bulk-motion Comptonization （BMC） process as was first suggested by Triimper et al., showing that the accretion scenario could be compatible with X- ray emission from AXPs/SGRs. Simulated results from the Hard X-ray Modulation Telescope using the BMC model show that the spectra would have discrepancies from the power-law, especially the cutoff at -200 keV. Thus future observations will allow researchers to distinguish different models of the hard X-ray emission and will help us understand the nature of AXPs/SGRs.

Concomitant Othello syndrome and impulse control disorders in a patient with Parkinson’s disease:A case report

BACKGROUND Othello syndrome(OS)is characterized by delusional beliefs concerning the infidelity of a spouse or sexual partner,which may lead to extreme behaviors.Impulse control disorders refer to behaviors involving repetitive,excessive,and compulsive activities driven by an intense desire.Both OS and impulse control disorders in Parkinson’s disease(PD)may be side effects of dopamine agonists.At present,there are only a few case reports and studies related to PD with concomitant OS and impulse control disorders.CASE SUMMARY We describe a 70-year-old male patient with PD,OS,and impulse control disorders,who presented with a six-month history of the delusional belief that his wife was having an affair with someone.He began to show an obvious increase in libido presenting as frequent masturbation.He had been diagnosed with PD ten years earlier and had no past psychiatric history.In his fourth year of PD,he engaged in binge eating,which lasted approximately one year.Both OS and hypersexuality were alleviated substantially after a reduction of his pramipexole dosage and a prescription of quetiapine.CONCLUSION Given its potential for severe consequences,OS should be identified early,especially in patients undergoing treatment with dopamine agonists.