Objective: Axillary lymph node dissection(ALND) may be unnecessary in 20%–60% of breast cancer patients with sentinel lymph node(NSLN) metastasis. The aim of the present study was to review the medical records of Chi...Objective: Axillary lymph node dissection(ALND) may be unnecessary in 20%–60% of breast cancer patients with sentinel lymph node(NSLN) metastasis. The aim of the present study was to review the medical records of Chinese patients with early-stage breast cancer and positive NSLN metastasis to identify clinicopathological characteristics as risk factors for non-NSLN metastasis.Methods: The medical records of 2008 early-stage breast cancer patients who received intraoperative sentinel lymph node biopsy(SLNB) between 2006 and 2016 were retrospectively reviewed. These patients were clinically and radiologically lymph nodenegative and had no prior history of receiving neoadjuvant chemotherapy or endocrinotherapy. The clinicopathological characteristics of patients with positive NSLN metastasis who underwent ALND were investigated.Results: In the present study, 296 patients with positive NSLN metastases underwent ALND. Positive non-NSLN metastases were confirmed in 95 patients(32.1%). On univariate analysis, ≥ 3 positive NSLN metastases(P <0.01), NSLN macrometastases(P =0.023), and lymphovascular invasion(P = 0.04) were associated with non-NSLN metastasis(P <0.05). In multivariate analysis, the number of positive SLNs was the most significant predictor of non-SLN metastasis. For patients with 0, 1, 2, or 3 associated risk factors, the non-SLN metastatic rates were 11.5%, 22.5%, 35.2%, and 73.1%, respectively.Conclusions: The number of positive NSLNs, NSLN macrometastases, and lymphovascular invasion were correlated with nonSLN metastasis. The number of positive SLNs was an independent predictor for non-NSLN metastasis. When 2 or 3 risk factors were present in one patient, the probability of non-NSLN was higher than that in the American College of Surgeons Oncology Group Z0011 trial(27.3%); thus, avoiding ALND should be considered carefully.展开更多
Traditionally,patch-based analysis at the landscape scale fragmentation has been used in the study of landscape ecology while the study of boundary and node has not been considered as much detail until recently.This s...Traditionally,patch-based analysis at the landscape scale fragmentation has been used in the study of landscape ecology while the study of boundary and node has not been considered as much detail until recently.This study investigated the possibility of applying boundary-and node-based methods in landscape pattern analysis to the upper reaches of the Minjiang River in the southwestern China.Boundary-based and node-based landscape indices were selected to be used in analyzing changes in landscape patterns,and the results were compared with analysis using traditional pattern indices.We compared the responses of patch-area-based,boundary-length-based and node-number-based indices,and concluded that boundary-based and node-based indices are more sensitive to disturbance than patch-based indices with various patterns,and node-based indices are even more sensitive than boundary-based ones.Thus,the results suggest that boundary-based and node-based pattern analysis methods provide helpful supplementary information to traditional patch-based pattern analysis methods.The results about pattern dynamics of landscapes in the upper reaches of the Minjiang River based on boundaries and nodes showed that with human disturbance,the dominance of forest landscape was weakened by other landscape types;thus the landscape pattern of the study area became more homogeneous and the boundary network became more complex.These changes further augmented disturbance interfaces in the landscape and increased the possibilities of further landscape fragmentation.展开更多
This paper presents a review of the studies on the structural performance of recycled aggregate concrete(RAC) elements and structures in the past 10 years in China.The flexural and shear behaviour of RAC beams,the com...This paper presents a review of the studies on the structural performance of recycled aggregate concrete(RAC) elements and structures in the past 10 years in China.The flexural and shear behaviour of RAC beams,the compression performance of RAC columns as well as the flexural performance of RAC slabs are overviewed and summarized.The seismic responses of beam-column joints,shear walls as well as frames made of RAC are also covered.The experimental observations indicate that the structural performance of RAC elements and structures is somewhat similar to that of natural aggregate concrete(NAC) members.A brief introduction to the application of RAC in sustainable buildings in China is also presented.展开更多
文摘Objective: Axillary lymph node dissection(ALND) may be unnecessary in 20%–60% of breast cancer patients with sentinel lymph node(NSLN) metastasis. The aim of the present study was to review the medical records of Chinese patients with early-stage breast cancer and positive NSLN metastasis to identify clinicopathological characteristics as risk factors for non-NSLN metastasis.Methods: The medical records of 2008 early-stage breast cancer patients who received intraoperative sentinel lymph node biopsy(SLNB) between 2006 and 2016 were retrospectively reviewed. These patients were clinically and radiologically lymph nodenegative and had no prior history of receiving neoadjuvant chemotherapy or endocrinotherapy. The clinicopathological characteristics of patients with positive NSLN metastasis who underwent ALND were investigated.Results: In the present study, 296 patients with positive NSLN metastases underwent ALND. Positive non-NSLN metastases were confirmed in 95 patients(32.1%). On univariate analysis, ≥ 3 positive NSLN metastases(P <0.01), NSLN macrometastases(P =0.023), and lymphovascular invasion(P = 0.04) were associated with non-NSLN metastasis(P <0.05). In multivariate analysis, the number of positive SLNs was the most significant predictor of non-SLN metastasis. For patients with 0, 1, 2, or 3 associated risk factors, the non-SLN metastatic rates were 11.5%, 22.5%, 35.2%, and 73.1%, respectively.Conclusions: The number of positive NSLNs, NSLN macrometastases, and lymphovascular invasion were correlated with nonSLN metastasis. The number of positive SLNs was an independent predictor for non-NSLN metastasis. When 2 or 3 risk factors were present in one patient, the probability of non-NSLN was higher than that in the American College of Surgeons Oncology Group Z0011 trial(27.3%); thus, avoiding ALND should be considered carefully.
基金Under the auspices of Major State Basic Research Development Program of China(No.2006CB403201)
文摘Traditionally,patch-based analysis at the landscape scale fragmentation has been used in the study of landscape ecology while the study of boundary and node has not been considered as much detail until recently.This study investigated the possibility of applying boundary-and node-based methods in landscape pattern analysis to the upper reaches of the Minjiang River in the southwestern China.Boundary-based and node-based landscape indices were selected to be used in analyzing changes in landscape patterns,and the results were compared with analysis using traditional pattern indices.We compared the responses of patch-area-based,boundary-length-based and node-number-based indices,and concluded that boundary-based and node-based indices are more sensitive to disturbance than patch-based indices with various patterns,and node-based indices are even more sensitive than boundary-based ones.Thus,the results suggest that boundary-based and node-based pattern analysis methods provide helpful supplementary information to traditional patch-based pattern analysis methods.The results about pattern dynamics of landscapes in the upper reaches of the Minjiang River based on boundaries and nodes showed that with human disturbance,the dominance of forest landscape was weakened by other landscape types;thus the landscape pattern of the study area became more homogeneous and the boundary network became more complex.These changes further augmented disturbance interfaces in the landscape and increased the possibilities of further landscape fragmentation.
基金supported by the Natural National Science Foundation of China (Grant No. 51178340)the Shanghai Science and Technology Committee (Grant No. 10231202000)the New Century Excellent Talents in China Ministry of Education Project (Grant No. NCET-06-0383)
文摘This paper presents a review of the studies on the structural performance of recycled aggregate concrete(RAC) elements and structures in the past 10 years in China.The flexural and shear behaviour of RAC beams,the compression performance of RAC columns as well as the flexural performance of RAC slabs are overviewed and summarized.The seismic responses of beam-column joints,shear walls as well as frames made of RAC are also covered.The experimental observations indicate that the structural performance of RAC elements and structures is somewhat similar to that of natural aggregate concrete(NAC) members.A brief introduction to the application of RAC in sustainable buildings in China is also presented.
