AIMTo evaluate the cytological diagnostic capacity and sample quality of the slow-pull technique and compare them with different suction techniques. METHODSFrom July 2010 to December 2015, 102 patients with pancreatic solid lesions who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with 22-gauge needles were retrospectively evaluated.EUS-FNA diagnosis was based on a cytological examination, and final diagnosis was based on a comprehensive standard of cytological diagnosis, surgical pathology and clinical or imaging follow-up.Cytological specimens were characterized for cellularity and blood contamination.The cytological diagnostic capacity and sample quality of the slow-pull technique and suction techniques with 5-mL/10-mL/20-mL syringes were analyzed.
The analysis of quality of life (QoL) data can be challenging due to the skewness of responses and the presence of missing data. In this paper, we propose a new weighted quantile regression method for estimating the conditional quantiles of QoL data with responses missing at random. The proposed method makes use of the correlation information within the same subject from an auxiliary mean regression model to enhance the estimation efficiency and takes into account of missing data mechanism. The asymptotic properties of the proposed estimator have been studied and simulations are also conducted to evaluate the performance of the proposed estimator. The proposed method has also been applied to the analysis of the QoL data from a clinical trial on early breast cancer, which motivated this study.
Background and Aims: There is a controversy regarding whether fingolimod is associated with an increased risk of infection in patients with multiple sclerosis (MS). We performed a systematic review and meta-analysis of data from randomized controlled trials (RCTs) to determine the risk of infection in these patients. Methods: We systematically searched PubMed, EMBASE, the Cochrane Library, and clinicaltrials.gov from inception to April 8, 2020, to identify RCTs that reported the occurrence of infection in patients with MS treated with fingolimod. Relative risks (RRs) and 95% confidence intervals (95% CIs) were calculated using the random-effects model. Results: Twelve RCTs including 8,448 patients were eligible. Compared with the control (placebo and other active treatments), fingolimod significantly increased the risk of infection (RR, 1.16; 95% CI, 1.07-1.27; I2, 81%), regardless of whether the infection was a general infection (RR, 1.14; 95% CI, 1.05-1.25; I2, 78%), or a serious infection (RR, 1.49; 95% CI, 1.06-2.10; I2, 0%). Analyses of subgroups found that fingolimod significantly increased the risk of lower respiratory infection (RR, 1.48; 95% CI, 1.19-1.85; I2, 0%) and herpes virus infection (RR, 1.34; 95% CI, 1.01-1.78; I2, 9%). There appears to be no dose-dependent increase in the risk of infection associated with fingolimod (0.5 mg: RR, 1.15; 95% CI, 1.07-1.25; I2, 91%; 1.25 mg: RR, 1.11; 95% CI, 0.97-1.28; I2, 81%; Pinteraction = 0.66). Conclusions: Compared with a placebo and other active treatments, fingolimod was associated with a 16% increase in the risk of infection, especially lower respiratory infection and herpes virus infection. The risk of infection associated with fingolimod might not be dose related.
Abstract: Radiotherapy can increase the cell cycle arrest that promotes apoptosis, reduces the risk of tumor recurrence and has become an irreplaceable component of systematic treatment for patients with breast cancer. Substantial advances in precise radiotherapy unequivocally indicate that the benefits of radiotherapy vary depending on intrinsic subtypes of the disease; luminal A breast cancer has the highest benefit whereas human epidermal growth factor receptor 2 (HER2)-positive and triple negative breast cancer (TNBC) are affected to a lesser extent irrespective of the selection of radiotherapy strategies, such as conventional whole-breast irradiation (CWBI), accelerated partial-breast irradiation (APBI), and hypofractionated whole-breast irradiation (HWBI). The benefit disparity correlates with the differential invasiveness, malignance, and radiosensitivity of the subtypes. A combination of a number of molecular mechanisms leads to the strong radioresistant profile of HER2-positive breast cancer, and sensitization to irradiation can be induced by multiple drugs or compounds in luminal disease and TNBC. In this review, we aimed to summarize the prognostic differences between various subtypes of breast tumors after CWBI, APBI, and HWBI, the potential reasons for drug-enhanced radiosensitivity in luminal breast tumors and TNBC, and the robust radioresistance of HER2-positive cancer. Keywords: radiotherapy, molecular subtype, breast cancer, molecular mechanism, radiosensitivity
Abstract Background: To integrate relevant clinical data of multicatheter accelerated partial breast irradiation (mAPBI) for reaching a comprehensive conclusion. Methods: We did 3 meta-analyses for clinical outcomes including 1740 women from 4 articles, for acute radiotherapy (RT)-associated toxicity including 1255 patients from 5 articles, and for late RT-related toxicity involving 1565 patients from 9 papers. Clinical outcomes analyses were stratified by molecular subtypes, lymph nodes status, receptor status, and human epidermal growth factor receptor 2 (HER2) status. Results: For the Luminal A/B phenotypes, the disease relapse and failure in survival significantly decreased when compared with triple negative (TN)/HER2-amplified subtypes ( P < .00001). The 5-year regional nodal recurrence (RNR), 5-year distant metastasis-free survival (DMFS) and 5-year disease free-survival (DFS) of TN patients were significantly superior to HER2-overexpression patients ( P < .00001). The 5-year cause-specific survival (CSS), 5-year DMFS and 5-year overall survival (OS) in women with lymph nodes-negative were significantly improved versus patients with lymph nodes-positive ( P = .0001). Conversely, the positive status of HER2 compared with negative one significantly increased the rate of local recurrence (LR) ( P = .02). For acute toxicity, the morbidity of dermatitis was significantly higher than hematoma and implant infection ( P = .01, P < .0001, respectively). For late toxicity, the occurrences of fibrosis (32%) and telangiectasia (14%) were significantly higher than other complications ( P < .0001). Conclusion: HER2-enriched subtype compared with other subtypes has significantly increased disease relapse and failure in survival. HER2-positive status is positively associated with an increased incidence of LR. Dermatitis is the most common acute RT-related toxicity and fibrosis is the first rife late RT-related toxicity.
In hierarchical structures determined by traditional routing protocols of wireless sensor networks, clustering is not structured and the networks prone to generate scatters, leading to some nodes die quickly. So this paper presents a cluster head preferred hierarchical clustering routing protocol based on G-Means (GHPHC). It uses G-Means algorithm to detect each clustering structure, so that each cluster is Gaussian distribution and it avoids the generation of scatters. At the same time, the cluster head preferred algorithm proposed in this paper gives the corresponding weight for each node of all clusters, thus select a suitable cluster head node for every cluster. Experimental results show that compared to traditional routing protocols, the death rate of nodes in a wireless sensor network which uses GHPHC protocol is more slow, and has a longer life cycle.
Aim We aimed to examine the relationship between the Triglyceride–glucose (TyG) index and the incidence of type 2 diabetes in people with different phenotypes of obesity. Methods From May 1, 1994 to December 31, 2016, 15,464 participants were enrolled in the medical examination program at the Murakami Memorial Hospital to determine the relationship between the TyG index and the incidence of type 2 diabetes in people with different phenotypes of obesity after 5.38 years of follow-up. Results Besides triglycerides, HbA1c%, and FPG, the incidence of type 2 diabetes was found to be significantly associated with the TyG index (p <0.001), age (p <0.001), BMI (p = 0.033), current smoker (p <0.001), and fatty liver (p <0.001). In participants with visceral fat obesity and/or ectopic fat obesity and normal BMI, the TyG index was significantly associated with the incidence of type 2 diabetes after adjusting for confounding factors. In patients with BMI ≥25 mg/m 2 , although there was a trend of the relationship between the TyG index and the incidence of type 2 diabetes, the relationship was no longer positive. Conclusion In participants with obesity involving visceral fat obesity and/or fatty liver and normal BMI which is not a measure of body fat distribution, there was a significant association between the TyG index and incidence of T2DM.
Abstract Background Axillary osmidrosis, characterized by an unpleasant odor, renders social life difficult for young adults. This study aimed to compare traditional open excision and use of the VERSAJET™ II Hydrosurgery System for effectiveness and treatment complaints in the treatment of axillary osmidrosis. Aim The current study aimed to assess the curative effect of VERSAJET™ for axillary osmidrosis in a prospective cohort study, comparatively to traditional open excision. Method In this prospective cohort study, from October 2016 to March 2018, 31 and 34 patients treated with the VERSAJET™ II Hydrosurgery System and traditional open excision, respectively, were recruited and followed up for 6 months post‐treatment. Treatment outcomes were assessed, including surgical field size, operation time, postoperative complications, odor elimination, hair growth reduction, scarring, and patient satisfaction. Results The VERSAJET™ group had significantly shorter operation ( P < .001) and lower rates of complications, including hematoma ( P = .014), wound dehiscence ( P = .048), and epidermal erosion ( P = .022) compared with the open excision group. A similar rate of good odor elimination ( P = .925) was observed in both groups (96.77% and 97.05% in the VERSAJET™ and open excision groups, respectively). Most patients experienced sparsity of armpit hair following both procedures. Based on a comprehensive consideration of the whole operation process, recovery process, postoperative odor and scar, patients in the VERSAJET™ group were more satisfied compared with those in the open excision group ( P = .008). Conclusion The VERSAJET™ II procedure is shorter, with less postoperative scarring and fewer postoperative complications, compared with the traditional method. Therefore, the VERSAJET™ II procedure is superior to traditional open excision, as a new, radical treatment method for axillary osmidrosis.
Proximal humerus fractures (PHFs) are common in the elderly and usually involve defects in the medial column.The current standard for medial column reconstruction is a lateral locking plate (LLP) in combination with either an intramedullary fibula support or an autogenous fibula graft. However, autogenous fibula graft can lead to additional trauma for patients and allogeneic fibular graft can increase patients’ economic burden and pose risks of infection and disease transmission. The primary objective of this study was to introduce and assess a novel “Sandwich” fixation technique and compare its biomechanical properties to the traditional fixation methods for PHFs. In this study, we established finite element models of two different internal fixation methods: LLP-intramedullary reconstruction plate with bone cement (LLP-IRPBC) and LLP-intramedullary fibula segment (LLP-IFS). The biomechanical properties of the two fixation methods were evaluated by applying axial, adduction, abduction, torsional loads and screw extraction tests to the models. These FEA results were subsequently validated through a series of biomechanical experiments. Under various loading conditions such as axial, adduction, abduction, and rotation, the LLP-IRPBC group consistently demonstrated higher structural stiffness and less displacement compared to the LLP-IFS group, regardless of whether the bone was in a normal (Nor) or osteoporotic (Ost) state. Under axial, abduction and torsional loads, the maximum stress on LLPs of LLP-IRPBC group was lower than that of LLP-IFS group, while under adduction load, the maximum stress on LLPs of LLP-IRPBC group was higher than that of LLP-IFS group under Ost condition, and almost the same under Nor condition. The screw-pulling force in the LLP-IRPBC group was 1.85 times greater than that of the LLP-IFS group in Nor conditions and 1.36 times greater in Ost conditions. Importantly, the results of the biomechanical experiments closely mirrored those obtained through FEA, confirming the accuracy and reliability of FEA. The novel “Sandwich” fixation technique appears to offer stable medial support and rotational stability while significantly enhancing the strength of the fixation screws. This innovative approach represents a promising strategy for clinical treatment of PHFs.
The paper's purpose is to cognize the characteristics of Chinese excellent curling players' volitional quality,which being as a helpful reference of scientific training.It has a quantitative research with the method of psychological measurement.The results show that the players' volitional qualities at different genders have significant difference in dimensionality of tenacity,namely women being better than men,but there are not significant differences between women and men in other 4 dimensionalities and the totals of 5 dimensionalities;the players' volitional qualities at different ages have significant difference in dimensionalities of decisiveness and tenacity;by mulriple comparisons at different training ages,the low-aged players are significantly different with middle-aged ones in decisiveness and with high-aged ones in decisiveness,tenacity and proactivity,the middle-aged players are significantly different with high-aged ones in tenacity.Its conclusion is that tenacity is the high-level players' unique-attribute,the most difference of volitional qualities is that the high-aged players as a whole are better than low-aged ones,the players' psychological ability has pivotal role in competition.
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