Nomogram-Based Risk Stratification to Identify Patients with T3N0M0 Breast Cancer with Survival Benefit from Postmastectomy Radiotherapy

BACKGROUND

The survival benefit of postmastectomy radiotherapy (PMRT) for patients with T3N0M0 breast cancer remains controversial. This study aimed to identify patients with a survival benefit from PMRT by developing a novel risk stratification model.

PATIENTS AND METHODS

The study recruited 2062 patients with pT3N0M0 breast cancer from the Surveillance, Epidemiology, and End Results (SEER) database who underwent mastectomy between 2010 and 2019. Overall survival (OS) and breast-cancer-specific survival (BCSS) prognostic nomograms based on multivariate Cox regression were constructed to quantify the survival risk and classify patients into low- and high-risk groups. Subgroup analyses were undertaken to assess the role of PMRT according to age and risk stratification.

RESULTS

In the overall cohort, PMRT was beneficial in improving OS in patients with pT3N0 breast cancer (5-year OS, non-PMRT versus PMRT: 76.6% vs. 84.2%, P < 0.001), while the benefit on BCSS was not significant (P = 0.084). On the basis of the risk stratification nomogram, in the high-risk group, PMRT improved OS in young patients by 10.1%, OS in elderly patients by 12.4%, and BCSS by 10.2% (P < 0.05), but the use of PMRT in the low-risk group did not improve OS and BCSS in all patients (P > 0.05).

CONCLUSIONS

We presented a new method for quantifying risk using the nomogram to identify patients with high risk of pT3N0M0 breast cancer. This study found that older patients in the newly constructed high-risk group benefited from OS and BCSS benefits from PMRT, while for younger high-risk patients, there was only a benefit in terms of OS.

Conditional survival nomogram predicting real-time prognosis of locally advanced breast cancer: Analysis of population-based cohort with external validation

Background

Locally advanced breast cancer (LABC) is generally considered to have a relatively poor prognosis. However, with years of follow-up, what is its real-time survival and how to dynamically estimate an individualized prognosis? This study aimed to determine the conditional survival (CS) of LABC and develop a CS-nomogram to estimate overall survival (OS) in real-time.

Methods

LABC patients were recruited from the Surveillance, Epidemiology, and End Results (SEER) database (training and validation groups, n = 32,493) and our institution (testing group, n = 119). The Kaplan-Meier method estimated OS and calculated the CS at year (x+y) after giving x years of survival according to the formula CS(y|x) = OS(y+x)/OS(x). y represented the number of years of continued survival under the condition that the patient was determined to have survived for x years. Cox regression, best subset regression, and the least absolute shrinkage and selection operator (LASSO) regression were used to screen predictors, respectively, to determine the best model to develop the CS-nomogram and its network version. Risk stratification was constructed based on this model.

Results

CS analysis revealed a dynamic improvement in survival occurred with increasing follow-up time (7 year survival was adjusted from 63.0% at the time of initial diagnosis to 66.4, 72.0, 77.7, 83.5, 89.0, and 94.7% year by year [after surviving for 1-6 years, respectively]). In addition, this improvement was non-linear, with a relatively slow increase in the second year after diagnosis. The predictors identified were age, T and N status, grade, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER 2), surgery, radiotherapy and chemotherapy. A CS-nomogram developed by these predictors and the CS formula was used to predict OS in real-time. The model's concordance indexes (C-indexes) in the training, validation and testing groups were 0.761, 0.768 and 0.810, which were well-calibrated according to the reality. In addition, the web version was easy to use and risk stratification facilitated the identification of high-risk patients.

Conclusions

The real-time prognosis of LABC improves dynamically and non-linearly over time, and the novel CS-nomogram can provide real-time and personalized prognostic information with satisfactory clinical utility.

Acetate promotes lipogenesis in adipocytes but not in hepatocytes of chickens

1.The role of acetate in lipogenesis of chickens remains largely unknown. This trial investigated the effect of sodium acetate (SA) on chicken fat metabolism via in vivo and in vitro experiments.2.The results indicated that supplementation of SA (1.0 g/kg feed) showed marginal to moderate stimulation on the area of the abdominal fat cells and triglyceride (TG) content in liver and adipose tissues. It increased the transcription of some genes involved in fat synthesis and deposition, but did not affect free fatty acid receptor 2 (FFAR2) expression in either liver or abdominal fat.3. In cultured hepatocytes treated with 0.01 mM to 5 mM SA, although mRNA levels of ACC1, PPAR, SREBP-1 c, and FFAR2 were upregulated with SA at certain concentrations, TG content and protein expression of lipogenic genes and FFAR2 were not altered at any dosages. In adipogenic differentiation of preadipocytes, high concentrations of SA (5 mM) exhibited significant increments in TG content and accumulated fat droplets, associated with stimulated transcription of FAS, LPL, AD, FABP4, and FFAR2, as well as elevated protein expression of FABP4 and FFAR2.4. The results showed that adipocytes were more sensitive to acetate than hepatocytes in chickens. While acetate played a minor role in hepatic fat metabolism, it promoted lipogenesis in adipocytes via FFAR2 with the involvement of FAS, LPL, and FABP4.

Association of serum galectin-3 with risks of death and vascular events in acute ischaemic stroke patients: the role of hyperglycemia

BACKGROUND AND PURPOSE

Whether the association between galectin-3 and stroke outcome is modified by fasting plasma glucose (FPG) is unknown. The aim was to evaluate the prognostic effect of galectin-3 amongst ischaemic stroke patients stratified by FPG.

METHODS

In all, 3082 ischaemic stroke patients were included in this study and serum galectin-3 was tested at baseline. The primary outcome was a composite outcome of death and vascular events, and secondary outcomes were death, stroke recurrence and vascular events within 1 year after stroke.

RESULTS

Increased galectin-3 was significantly associated with the primary outcome, stroke recurrence and vascular events in the patients with hyperglycemia but not in those with normoglycemia (P for interaction < 0.05 for all). The multivariate-adjusted hazard ratios (95% confidence intervals) were 1.72 (1.05-2.84), 2.64 (1.14-6.12) and 2.68 (1.33-5.38) for the primary outcome, stroke recurrence and vascular events, respectively. A linear association between galectin-3 and the primary outcome was observed in hyperglycemic patients (P for linearity = 0.007).

CONCLUSION

Increased galectin-3 was associated with the primary outcome, stroke recurrence and vascular events within 1 year after stroke in the patients with hyperglycemia, suggesting that galectin-3 may be an important prognostic factor for ischaemic stroke patients with hyperglycemia.

Serum 25-hydroxyvitamin D deficiency predicts poor outcome amongst acute ischaemic stroke patients with low high density lipoprotein cholesterol

BACKGROUND AND PURPOSE

Current observational studies indicate that a lower vitamin D level is associated with a higher risk of poor ischaemic stroke prognosis. Whether this association is affected by lipid levels is unclear. Our aim was to examine the effect of serum vitamin D especially its deficiency on the global outcome of ischaemic stroke stratified by individual lipid component level.

METHODS

A total of 3181 ischaemic patients from China Antihypertensive Trial in Acute Ischaemic Stroke were included in this study and their baseline serum 25-hydroxyvitamin D levels were tested. They were prospectively followed up for death, major disability and vascular events for 3 months after acute ischaemic stroke. A multivariable logistic model was used to evaluate the association between serum 25-hydroxyvitamin D levels and clinical outcomes of ischaemic stroke in the 3-month period of follow-up in all patients and in different lipid-level subgroups.

RESULTS

Vitamin D deficiency was associated with poor clinical outcomes only in ischaemic stroke patients with high density lipoprotein cholesterol (HDLC) <1.04 mmol/l rather than all patients. The multivariable adjusted odds ratios (95% confidence intervals) of major disability and composite adverse events were 1.98 (1.08-3.63) and 2.24 (1.22-4.12), respectively. There was a significant interaction effect between vitamin D and HDLC levels on major disability and the composite outcome (P for interaction < 0.05 for both). A significant linear trend existed between 25-hydroxyvitamin D and risk of poor prognosis (P = 0.03).

CONCLUSIONS

Vitamin D deficiency may be merely an independent risk factor of poor prognosis in ischaemic stroke patients with low HDLC level.

Association between an alternative promoter polymorphism and sperm deformity rate is due to modulation of the expression of KATNAL1 transcripts in Chinese Holstein bulls

Katanin p60 subunit A-like 1 (KATNAL1) is an ATPase that regulates Sertoli cell microtubule dynamics and sperm retention. We evaluated one novel splice variant and characterized the promoter and a functional single nucleotide polymorphism (SNP) of the bovine KATNAL1 gene to explore its expression pattern, possible regulatory mechanism and relationship with semen traits in Chinese Holstein bulls. A novel splice variant, KATNAL1 transcript variant 2 (KATNAL1-TV2) of the retained 68 bp in intron 2, was identified by RT-PCR and compared with KATNAL1 transcript variant 1 (KATNAL1-TV1, NM 001192918.1) in various tissues. Bioinformatics analyses predicted that KATNAL1 transcription was regulated by two promoters: P1 in KATNAL1-TV1 and P2 in KATNAL1-TV2. Results of qRT-PCR revealed that KATNAL1-TV1 had higher expression than did KATNAL1-TV2 in testes of adult bulls (P < 0.05). Promoter luciferase activity analysis suggested that the core sequences of P1 and P2 were mapped to the region of c.-575˜c.-180 and c.163-40˜c.333+59 respectively. One novel SNP (c.163-210T>C, ss836312085) located in intron 1 was found using sequence alignment. The SNP in P2 resulted in the presence of the DeltaE binding site, improving its basal promoter activity (P < 0.05); and we observed a greater sperm deformity rate in bulls with the genotype CC than in those with the genotype TT (P < 0.05), which indicated that different genotypes were associated with the bovine semen traits. Bioinformatics analysis of the KATNAL1 protein sequence predicted that the loss of the MIT domain in the KATNAL1-TV2 transcript resulted in protein dysfunction. These findings help us to understand that a functional SNP in P2 and subsequent triggering of expression diversity of KATNAL1 transcripts are likely to play an important role with regard to semen traits in bull breeding programs.

Telomeres and telomerase in stem cells during aging and disease

Cell cycle checkpoints induced by telomere dysfunction represent one of the major in vivo tumor suppressor mechanisms preventing cancer but at the same time provoking age dependent decline in self-renewal and regeneration of tissues and organs. On the other hand, telomere shortening contributes to the initiation of cancer by inducing chromosomal instability. Telomere function and telomerase activity are mainly associated with actively proliferating cells. Since stem cells are continuously proliferating throughout lifetime, it is of great interest to explore the role of telomeres and telomerase in stem cells. Although most stem cell compartments express telomerase, the level of telomerase activity is not sufficient to maintain telomere length of stem cells during aging. Stem cells appear to have tighter DNAdamage checkpoint control in comparison to somatic cells, which may reflect the need to protect this long lasting cell compartment against malignant transformation. These enhanced checkpoint responses may have a detrimental impact on stem cell function, by causing increased sensitivity towards senescence or apoptosis induced by telomere shortening. This review summarizes our knowledge on telomere dynamics and its functional impact on stem cells during aging and transformation.

Telomere shortening and ageing

Telomeres form the ends of human chromosomes. Telomeres shorten with each round of cell division and this mechanism limits proliferation of human cells to a finite number of cell divisions by inducing replicative senescence, differentiation, or apoptosis. Telomere shortening can act as a tumor suppressor. However, as a downside, there is growing evidence indicating that telomere shortening also limits stem cell function, regeneration, and organ maintenance during ageing. Moreover, telomere shortening during ageing and disease is associated with increasing cancer risk. In this review we summarize our current knowledge on the role of telomere shortening in human ageing, chronic diseases, and cancer.

Global detection of molecular changes reveals concurrent alteration of several biological pathways in nonsmall cell lung cancer cells

To identify the molecular changes that occur in non-small cell lung carcinoma (NSCLC), we compared the gene expression profile of the NCI-H292 (H292) NSCLC cell line with that of normal human tracheobronchial epithelial (NHTBE) cells. The NHTBE cells were grown in a three-dimensional organotypic culture system that permits maintenance of the normal pseudostratified mucociliary phenotype characteristic of bronchial epithelium in vivo. Microarray analysis using the Affymetrix oligonucleotide chip U95Av2 revealed that 1,683 genes showed a >1.5-fold change in expression in the H292 cell line relative to the NHTBE cells. Specifically, 418 genes were downregulated and 1,265 were upregulated in the H292 cells. The expression data for selected genes were validated in several different NSCLC cell lines using quantitative real-time PCR and Western analysis. Further analysis of the differentially expressed genes indicated that WNT responses, apoptosis, cell cycle regulation and cell proliferation were significantly altered in the H292 cells. Functional analysis using fluorescence-activated cell sorting confirmed concurrent changes in the activity of these pathways in the H292 line. These findings show that (1) NSCLC cells display deregulation of the WNT, apoptosis, proliferation and cell cycle pathways, as has been found in many other types of cancer cells, and (2) that organotypically cultured NHTBE cells can be used as a reference to identify genes and pathways that are differentially expressed in tumor cells derived from bronchogenic epithelium.

Differential gene expression in the brain of channel catfish (Ictalurus punctatus) in response to cold acclimation

Aquatic ectotherms can adapt to a wide range of temperature changes, but the molecular mechanisms that underlie this adaptability are not well understood. We identified genes that are differentially expressed in the catfish ( Ictalurus punctatus) brain using a cDNA microarray approach to gain an initial understanding of adaptation to low temperature. Among 660 genes analyzed, 61 were differentially expressed when compared at 12 degrees C and 24 degrees C. Gene induction was rapid, occurring within 2 h of the temperature shift. The major categories of differentially expressed genes included (1) genes for chaperones such as Hsp70 and Hsp70/Hsp90 organizing protein; (2) genes for transcription factors and gene products involved in signal transduction pathways such as zinc-finger proteins, calmodulin kinase inhibitor, the nuclear autoantigen SG2NA, interferon regulatory factor 3, and inorganic pyrophosphatase; (3) genes involved in lipid metabolism such as TB2 and acyl CoA binding protein; and (4) genes involved in the translational machinery such as ribosomal proteins. Some genes were induced transiently, whereas others were induced in an enduring fashion. Several genes, primarily ribosomal protein genes, were down regulated, indicating reduced metabolic activities after extended incubation at the low temperature. Thus channel catfish respond to low temperature by adjusting expression of a large number of genes. The rapid induction of proteins involved in signal transductions and chaperones suggests that both de novo synthesis of cold-induced proteins and modification of existing proteins are required for adaptation and tolerance of catfish to low environmental temperature.

Microsatellite-containing genes from the channel catfish brain: evidence of trinucleotide repeat expansion in the coding region of nucleotide excision repair gene RAD23B

Expansion of trinucleotide repeats within genes is well known to cause pathological conditions in humans. Here we report a large number of genes containing simple sequence repeats (SSR) from the brain of channel catfish, of which a homologue of the RAD23B gene was found to include (CCA) trinucleotide repeats within its coding region. Because of the importance of the RAD23B gene in the nucleotide excision repair (NER) system, the catfish RAD23B locus was further characterized. The (ACC) repeats encode a polythreonine (T) tract within the catfish RAD23B gene that is absent from the previously cloned human and mouse genes. A survey of the allele variation at the locus indicated the existence of variable microsatellite repeats in the NER RAD23B gene, suggesting that the trinucleotide repeats are expanding or shrinking. The majority of individuals harbor 10 (ACC) repeats within the RAD23B gene, but alleles with 8 and 11 repeats were also detected. The (ACC) repeats are limited to only channel catfish and the closely related blue catfish, but are absent from flathead catfish and the cloned human and mouse genes, suggesting that the microsatellite invasion into the RAD23B gene is a recent event in evolution.

Transcriptome of channel catfish (Ictalurus punctatus): initial analysis of genes and expression profiles of the head kidney

Analysis of expressed sequence tags (ESTs) is an efficient approach for gene discovery, expression profiling, and development of resources useful for functional genomics studies. As part of the transcriptome analysis in channel catfish (Ictalurus punctatus), we have conducted EST analysis using a cDNA library made from the head kidney. We analysed 2228 EST clones. Orthologues were established for 1495 (67.1%) clones representing 748 genes, of which 545 (36.5%) clones were singletons. The remaining 733 (32.9%) clones represent unknown gene clones, for which the number of genes has not yet been determined.

Transcriptome analysis of channel catfish (Ictalurus punctatus): genes and expression profile from the brain

Expressed sequence tag (EST) analysis was conducted using a complementary DNA (cDNA) library made from the brain mRNA of channel catfish (Ictalurus punctatus). As part of our transcriptome analysis in catfish to develop molecular reagents for comparative functional genomics, here we report analysis of 1201 brain cDNA clones. Of the 1201 clones, 595 clones (49.5%) were identified as known genes by BLAST searches and 606 clones (50.5%) as unknown genes. The 595 clones of known gene products represent transcripts of 251 genes. These known genes were categorized into 15 groups according to their biological functions. The largest group of known genes was the genes involved in translational machinery (21.4%) followed by mitochondrial genes (6.2%), structural genes (3.1%), genes homologous to sequences of unknown functions (2.3%), enzymes (2.7%), hormone and regulatory proteins (2.5%), genes involved in immune systems (2.1%), genes involved in sorting, transport, and metal metabolism (1.8%), transcriptional factors and DNA repair proteins (1.6%), proto-oncogenes (1.2%), lipid binding proteins (1.2%), stress-induced genes (0.7%), genes homologous to human genes involved in mental diseases (0.6%), and development or differentiation-related genes (0.3%). The number of genes represented by the 606 clones of unknown genes is not known at present, but the high percentage of clones showing no homology to any known genes in the GenBank databases may indicate that a great number of novel genes exist in teleost brain.

[Study on normal pregnancy and recurrent spontaneous abortions from helper T cell 1/helper T cell 2 cytokines balance]

OBJECTIVE

To investigate the function of Th1 (IFN-gamma, TNF-alpha) and Th2 (IL-4, IL-10) cytokine balance in the maternal-fetal tolerance.

METHODS

The IFN-gamma, TNF-alpha, IL-4 and IL-10 mRNA were studied from PBMCs of 11 normal non-pregnancy control, 10 women in first trimester of normal pregnancy, 11 women in last trimester of normal pregnancy by semi-quantitative reverse transcriptional-polymerase chain reaction (RT-PCR) method.

RESULTS

(1) The IFN-gamma mRNA decreased [(24.68 +/- 5.55)%, P < 0.05], while the IL-10 mRNA rose [(20.72 +/- 5.36)%, P < 0.01] in normal pregnancy women compared with the non-pregnancy control [IFN-gamma(30.76 +/- 5.35)%, IL-10 (13.58 +/- 3.91)%]. (2) IL-10 mRNA decreased [(9.48 +/- 2.84)%, P < 0.05], while the IFN-gamma mRNA rose [(36.08 +/- 5.75)%, P < 0.05] in RSA women compared with the non-pregnancy control. (3) The IFN-gamma mRNA rose (P < 0.01), while the IL-10 mRNA decreased (P < 0.01) in RSA women compared with women in their first trimester of normal pregnancy [IFN-gamma(27.23 +/- 5.74)%, IL-10 (18.61 +/- 5.43)%].

CONCLUSIONS

The results suggest that women in normal pregnancy had mainly the Th2 cytokines. The breakage of the Th1/Th2 balance may result in RSA. The results provide clue that Th1/Th2 balance plays a role in maternal-fetal tolerance.

Stripped corn oil controls scald and maintains volatile production potential in golden supreme and delicious apples

Effects of stripped (alpha-tocopherol < 5 mg L(-)(1)) corn oil on flesh firmness, skin color, acidity, soluble solids content (SSC), scald, and fruit volatiles during 6 months at 0 degrees C were studied using Golden Supreme and Delicious apples. Treatment with 10% oil emulsion reduced production of ethylene, alpha-farnesene, and major volatile esters in the first 3 months of storage, but this trend reversed after 5 months. After 6 months at 0 degrees C plus 7 days at 20 degrees C, oil-treated fruit were firmer and greener and had higher levels of titratable acidity than the controls. In addition, control fruit developed 27% and 42% scald in Golden Supreme and Delicious apples, respectively, whereas oil-treated fruit were free from scald. Soluble solids content and ethanol production were unaffected by oil treatment.

[Column chromatographic preconcentration of trace copper in natural water using dithizone supported on naphthalene and determined by atomic absorption spectrometer]

In this paper a column chromatographic preconcentration method using dithizone supported on naphthalene for copper in natural water is provided. The dissolving reagent is dimethylformamide (DMF). The dissolving solution is determined by atomic absorption spectrometer. The effect of pH, the flow rate of water samples, the choice of dissolving reagent, the effect of diverse ions were studied. RSD is 2.3%. The recoveries for the added standard are between 96%-103%. This method was applied to determined trace copper in natural water samples and standard water samples with satisfactory results.

[Combined surgical-orthodontic correction for mandibular protrusion]

Through the analysis of the treatment plans and the results of 159 patients with mandibular prognathism, the authors emphasized that orthodontic treatment plays an important role in the combined procedure in which the aims of orthodontic treatment include eliminating dental compensation, aligning the teeth, harmonizing arch compatibility, adjusting and maintaining occlusal relationship. The choice of surgical procedure used for setting back the mandible is closely related to the result of pre-operative orthodontic treatment. The body step osteotomy and vertical ramus osteotomy are the most commonly used procedure to set back the mandible after pre-operative orthodontic preparation.

Presurgical orthodontic decompensation of mandibular incisors

The effects of presurgical orthodontic decompensation on lower incisor inclination and angle ANB were studied using a modified Pancherz method of cephalometric analysis. Two groups of patients with mandibular hyperplasia were studied: one group (Group 1) of nineteen cases which required orthodontic decompensation and another (Group 2) of twenty-one cases which did not. The cephalometric changes which occurred in Group 1 were compared with the significant cephalometric differences existing between the two groups with respect to incisor inclination (ILi/OL; P < .001) and the sagittal relation (ANB; P < 0.05). After orthodontic treatment the average lower incisal angulation of the treated group was the same as that in the untreated group; the variations (S.D) being 3.6 degrees and 7.4 degrees respectively indicating that the clinical assessment of the orthodontic treatment effect was quite high.

[Evaluation of presurgical orthodontic correction of the mandibular prognathism]

The aim of this study was to evaluate the effects of presurgical orthodontic correction of the mandibular prognathism. The sample consisted of two groups of surgical cases. The cases of the mandibular prognathism in group I with lower anterior dental compensation received presurgical orthodontic decompensation, and the cases in group II without lower anterior dental compensation did not receive presurgical orthodontic decompensation. The results showed that before presurgical orthodontic treatment, significantly differences existed between the two groups variable ILi/OL and ANB. After presurgical orthodontic correction lower incisors position in group I was very close to that in the group II, this means that the presurgical orthodontic treatment significantly changed the position of the lower incisors.