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Sheng-En Chou,1 Cheng-Shyuan Rau,2 Wei-Ti Su,1 Ching-Hua Tsai,1 Shiun-Yuan Hsu,1 Ching-Hua Hsieh1 1Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 2Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanCorrespondence: Ching-Hua Hsieh, Tel +886-7-7327476, Email m93chinghua@gmail.comIntroduction: The albumin-bilirubin (ALBI) grade objectively assesses liver function with better performance than the Child-Pugh and end-stage liver disease scores. However, the evidence is lacking on the ALBI grade in trauma cases. This study aimed to identify the association between the ALBI grade and mortality outcomes in trauma patients with liver injury.Methods: Data from 259 patients with traumatic liver injury at a level I trauma center between January 1, 2009, and December 31, 2021 were retrospectively analyzed. Independent risk factors for predicting mortality were identified using multiple logistic regression analysis. Participants were characterized by ALBI score into grade 1 (≤ − 2.60, n = 50), grade 2 (− 2.60 < and ≤ − 1.39, n = 180), and grade 3 (> − 1.39, n = 29).Results: Compared to survival (n = 239), death (n = 20) was associated with a significantly lower ALBI score (2.8± 0.4 vs 3.4± 0.7, p < 0.001). The ALBI score was a significant independent risk factor for mortality (OR, 2.79; 95% CI, 1.27– 8.05; p = 0.038). Compared with grade 1 patients, grade 3 patients had a significantly higher mortality rate (24.1% vs 0.0%, p < 0.001) and a longer hospital stay (37.5 days vs 13.5 days, p < 0.001).Discussion: This study showed that ALBI grade is a significant independent risk factor and an useful clinical tool to discover liver injury patients who are more susceptible to death.Keywords: trauma, liver injury, mortality, albumin-bilirubin grade, ALBI grade, liver function

The De Ritis ratio is widely used to differentiate various causes of liver disease and serves as an independent prognostic predictor for different malignancies and non-malignant illnesses. This retrospective study aimed to identify the association between the De Ritis ratio on admission and mortality outcomes in adult thoracoabdominal trauma patients. A total of 2248 hospitalized adult trauma patients with thoracoabdominal injury, defined as an abbreviated injury scale (AIS) score ≥ 1 in the thoracic and abdominal regions, between 1 January 2009, and 31 December 2019, were included. They were categorized into three tertile groups according to the De Ritis ratio. A 1:1 propensity score-matched study group was established to attenuate the confounding effect of patient characteristics on the mortality outcome assessment. The AST levels of the tertile 1, 2, and 3 groups were 115.8 ± 174.9, 115.7 ± 262.0, and 140.5 ± 209.7 U/L, respectively. Patients in the tertile 3 group had a significantly higher level of AST than those in the tertile 1 group (p = 0.032). In addition, patients in the tertile 1 group had a significantly higher level of ALT than those in the tertile 2 and 3 groups (115.9 ± 158.1 U/L vs. 74.5 ± 107.0 U/L and 61.9 ± 86.0 U/L, p < 0.001). The increased De Ritis ratio in trauma patients with thoracoabdominal injuries was mainly attributed to elevated AST levels. The propensity score-matched patient cohorts revealed that the patients in the tertile 3 group presented a 3.89-fold higher risk of mortality than the patients in the tertile 2 group. In contrast, the patients in the tertile 1 group did not have a significantly different mortality rate than those in the tertile 2 group. This study suggests that a De Ritis ratio > 1.64 may be a useful biomarker to identify patients with a higher risk for mortality.

Background: The use of helmets has been promoted worldwide to protect motorcyclists from head-and-neck injuries and to reduce motorcycle accident-related mortality. However, the results of previous studies regarding the effectiveness of different types of helmets are controversial. This study aims to investigate the effectiveness of three types of helmets: half-helmets, open-face helmets, and full-face helmets, in protecting motorcyclists during traffic accidents. Materials and Methods: A total of 6991 motorcyclists, who were hospitalized between January 1, 2015, and December 31, 2019, were enrolled in this study. They were divided into two groups: those who did not wear helmets (n = 506) and those who wore helmets (n = 6,485). The latter group was subdivided according to the type of helmet used: half-helmet (n = 3,027), open-face helmet (n = 2,528), and full-face helmet (n = 930). The primary outcome was inhospital mortality. The length of hospital stay and associated head-and-neck injuries were secondary outcomes. Results: Half-helmets offered significantly less protection than full-face helmets, considering that patients using half-helmets had a significantly higher rate of the Abbreviated Injury Scale ≥ 2 injuries to the head region and significantly higher odds of sustaining subdural hematoma, subarachnoid hemorrhage (SAH), and intracerebral hematoma than patients using full-face helmets. However, higher odds of sustaining SAH were noted in patients using open-face helmets. There were no significant differences in the Glasgow Coma Scale score after injury or in the mortality rate in patients using either half-helmets or open-face helmets compared to those using full-face helmets. Conclusion: This study revealed that half-helmets, but not open-face helmets, offered significantly less protection from head injuries than full-face helmets. However, the mortality rate and length of hospital stay after the injury did not differ among patients using the three types of helmets.

Summary Background Breast cancer is a collection of molecularly and clinically distinct neoplastic disease. Recent research has shown the information regarding gene expression in breast cancer could be beneficial in the designing of an optimal treatment plan and may also provide with prognostic information. The creation of tissue microarrays (TMA) allows for the rapid immunohistochemical analysis of thousands of tissue samples in parallel with minimal damage to the original blocks. This study was designed with the application of tissue microarray (TMA) to analyze the afamin status in breast cancer with the hope of elucidating the possible relationship between afamin expressions and breast cancer. Methods Archival tissue specimens from 106 patients with primary invasive breast cancer were analyzed for afamin expression by immunhistochemical staining with TMA. Results were compared to clinicopathologic data by multivariate analysis. Results TNM stage has shown significant relationship to the overall 5-year survival rate. However, afamin expression was not significantly related to overall five-year survival. Conclusion Immunohistochemical staining with TMA was convenient and feasible for analyzing afamin expression status in breast cancer. Our preliminary results show that afamin expression showed no significant prognostic value in breast cancer.

Wei-Ti Su,1 Ching-Hua Tsai,1 Chun-Ying Huang,1 Sheng-En Chou,1 Chi Li,1 Shiun-Yuan Hsu,1 Ching-Hua Hsieh2 1Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 2Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanCorrespondence: Ching-Hua HsiehDepartment of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Ta-Pei Road, Niao-Song District, Kaohsiung City, 833, TaiwanTel +886-7-7327476Email m93chinghua@gmail.comBackground: The Geriatric Nutritional Risk Index (GNRI) is a simple and objective screening tool for clinicians to screen patients’ nutritional status based on serum albumin level and their weight and height. The original study had divided patients based on GNRI into quartiles of nutritional risk for death: a no-risk group (GNRI > 98), a low-risk group (GNRI 92– 98), a moderate-risk group (GNRI 82 to < 92), and a major-risk group (GNRI < 82). Given that the patients generally sustained traumatic brain injury (TBI) in an acute condition, the study aimed to explore whether GNRI presents a prognostic value for the mortality outcome of these patients.Methods: From January 1, 2009, to December 31, 2019, 581 elderly patients with moderate to severe TBI, which was defined as sustaining a head Abbreviated Injury Scale ≥ 3, was included in the study population. The collected data included age, sex, body mass index, serum albumin levels at admission, preexisting comorbidities, Glasgow Coma Scale, and Injury Severity Score. The primary outcome in the comparison was in-hospital mortality.Results: Multivariate logistic regression analysis revealed that GNRI, ESRD, and ISS were significant independent risk factors for mortality in patients with moderate to severe TBI. When subgrouping the study population into four nutritional risk categories according to the quartile deviation as Q1 (GNRI < 85, n = 145), Q2 (GNRI 85 to < 93.8 n = 145), Q3 (GNRI 93.8 to 103, n = 145), and Q4 (GNRI > 103, n = 146), Q1 patients had a significantly longer LOS in hospital (25.2 days vs 18.6 days, respectively; p = 0.004) and higher mortality rate (28.3% vs 11.7%, respectively; p < 0.001) than Q4 patients. The mortality rate was significantly higher in Q1 patients than in Q4 patients (OR, 2.8; 95% CI, 1.14– 6.78; p = 0.021).Conclusion: This study revealed that the GNRI is a significant independent risk factor and a promising simple assessment tool for mortality in elderly patients with moderate to severe TBI.Keywords: elderly, malnutrition, mortality, Geriatric Nutritional Risk Index, GNRI, trauma, traumatic brain injury, TBI

Background. After trauma, the subtypes of white blood cells (WBCs) in circulation and the derived neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) may undergo relative changes and reflect the patients’ immune-inflammatory status and outcome. This retrospective study was designed to investigate the relationship between these variables and the mortality outcomes in adult patients with polytrauma, which is defined as an abbreviated injury scale (AIS) score ≥ 3 in two or more different body regions. Methods. A comparison of the expression of subtypes of WBCs, NLR, MLR, and PLR upon arrival to the emergency department was performed in selected propensity score-matched patient cohorts created from 479 adult patients with polytrauma between 1 January 2015 and 31 December 2019. A multivariate logistic regression analysis was used to identify the independent risk factors for mortality. Results. There were no significant differences in monocyte, neutrophil, and platelet counts, as well as in MLR, NLR, and PLR, between deceased (n = 118) and surviving (n = 361) patients. In the propensity score-matched patient cohorts, which showed no significant differences in sex, age, comorbidities, and injury severity, deceased patients had significantly higher lymphocyte counts than survivors (2214 ± 1372 vs. 1807 ± 1162 [106/L], respectively, p = 0.036). In addition, the multivariate logistic regression analysis revealed that the lymphocyte count (OR, 1.0; 95% confidence interval [CI], 1.00–1.06; p = 0.043) was a significant independent risk factor for mortality in these patients. Conclusions. This study revealed that there was no significant difference in the counts of monocytes, neutrophils, and platelets, as well as in MLR, NLR, and PLR, between deceased and surviving patients with polytrauma. However, a significantly higher lymphocyte count may be associated with a worse mortality.

The geriatric nutritional risk index (GNRI) is a simple and efficient tool to assess the nutritional status of patients with malignancies or after surgery. Because trauma patients constitute a specific population that generally acquires accidental and acute injury, this study aimed to identify the association between the GNRI at admission and mortality outcomes of older trauma patients in the intensive care unit (ICU). Methods: The study population included 700 older trauma patients admitted to the ICU between 1 January 2009 and 31 December 2019. The collected data included age, sex, body mass index (BMI), albumin level at admission, preexisting comorbidities, injury severity score (ISS), and in-hospital mortality. Multivariate logistic regression analysis was conducted to identify the independent effects of univariate predictive variables resulting in mortality in our study population. The study population was categorized into four nutritional risk groups: a major-risk group (GNRI &lt, 82, n = 128), moderate-risk group (GNRI 82 to &lt, 92, n = 191), low-risk group (GNRI 92&ndash, 98, n = 136), and no-risk group (GNRI &gt, n = 245). Results: There was no significant difference in sex predominance, age, and BMI between the mortality (n = 125) and survival (n = 575) groups. The GNRI was significantly lower in the mortality group than in the survival group (89.8 &plusmn, 12.9 vs. 94.2 &plusmn, 12.0, p &lt, 0.001). Multivariate logistic regression analysis showed that the GNRI (odds ratio&mdash, OR, 0.97, 95% confidence interval (CI) 0.95&ndash, 0.99, p = 0.001), preexisting end-stage renal disease (OR, 3.6, 95% CI, 1.70&ndash, 7.67, p = 0.001), and ISS (OR, 1.1, 95% CI, 1.05&ndash, 1.10, p &lt, 0.001) were significant independent risk factors for mortality. Compared to the patients in group of GNRI &gt, 98, those patients in group of GNRI &lt, 82 presented a significantly higher mortality rate (26.6% vs. 13.1%, 0.001) and length of stay in hospital (26.5 days vs. 20.9 days, p = 0.016). Conclusions: This study demonstrated that GNRI is a significant independent risk factor and a promising simple screening tool to identify the subjects with malnutrition associated with higher risk for mortality in those ICU elderly trauma patients.

Background: Malnutrition is frequently underdiagnosed in geriatric patients and is considered to be a contributing factor for worse outcomes during hospitalization. In addition, elderly patients who undergo trauma are often malnourished at the time of incurring fractures. The geriatric nutritional risk index (GNRI), calculated based on the serum albumin level and the ratio of present body weight to ideal body weight, was proposed for the assessment of the nutritional status of elderly patients with various illnesses. This study aimed to investigate whether the GNRI has a prognostic value that links the nutritional status and mortality outcomes of elderly patients who have previously undergone trauma with femoral fractures. Methods: From January 1, 2009 to December 31, 2019, a total of 678 elderly patients with femoral fractures were categorized into four nutritional risk groups: a major-risk group (GNRI &lt, 82, group 1, n = 127), moderate-risk group (GNRI 82&ndash, &lt, 92, group 2, n = 179), low-risk group (GNRI 92&ndash, 98, group 3, n = 123), and no-risk group (GNRI &gt, group 4, n = 249). To minimize the confounding effects of sex, age, preexisting comorbidities, and injury severity of patients on outcome measurements, propensity score-matched patient cohorts were created to assess the impact of patients being in different nutritional risk groups on the in-hospital mortality outcomes against the no-risk group. Results: The patients in groups 1&ndash, 3 were significantly older and presented a significantly lower body mass index and lower serum albumin levels than those in group 4. Compared with patients in group 4 (3.6%), a significantly higher mortality rate was found in the patients in group 1 (17.3%, p &lt, 0.001), but not in those in group 2 (6.7%) or group 3 (2.4%). The study of propensity score-matched patient cohorts provided similar results, group 1 patients had significantly higher odds of mortality than group 4 patients (odds ratio, 6.3, 95% confidence interval, 1.34&ndash, 29.37, p = 0.009), but there were no significant differences in mortality risks among patients in groups 2 and 3 compared with those in group 4. Conclusions: This preliminary study suggested that the GNRI may be used as a screening tool to identify patients with malnutrition at a high risk of mortality among elderly patients with femoral fractures. A prospective study is needed to validate the suggestion.

Background: Accidental falls are a common cause of injury and deaths. Both ground-level falls (GLF) and non-GLF may lead to significant morbidity or mortality. This study aimed to explore the relationship between height of falls and mortality. Method: This is a retrospective study based on the data from a registered trauma database and included 8699 adult patients who were hospitalized between 1 January 2009 and 31 December 2017 for the treatment of fall-related injuries. Study subjects were divided into three groups of two categories based on the height of fall: GLF (group I: &lt, 1 m) and non-GLF (group II: 1&ndash, 6 m and group III: &gt, 6 m). The primary outcome was in-hospital mortality. The adjusted odds ratio (AOR) of mortality adjusted for age, sex, and comorbidities with or without an injury severity score (ISS) was calculated using multiple logistic regression. Results: Among the 7001 patients in group I, 1588 in group II, and 110 in group III, patients in the GLF group were older, predominantly female, had less intentional injuries, and had more pre-existing comorbidities than those in the non-GLF group. The patients in the non-GLF group had a significantly lower Glasgow Coma Scale (GCS), a higher injury severity score (ISS), worse physiological responses, and required more procedures performed in the emergency department. The mortality rate for the patients in group I, II, and III were 2.5%, 3.5%, and 5.5%, respectively. After adjustment by age, sex, and comorbidities, group II and group III patients had significantly higher adjusted odds of mortality than group I patients (AOR 2.2, 95% CI 1.64&ndash, 2.89, p &lt, 0.001 and AOR 2.5, 95% CI 1.84&ndash, 3.38, p &lt, 0.001, respectively). With additional adjustment by ISS, group II did not have significantly higher adjusted odds of mortality than group I patients (AOR 1.4, 95% CI 0.95&ndash, 2.22, p = 0.082), but group III patients still had significantly higher adjusted odds of mortality than group I patients (AOR 10.0, 95% CI 2.22&ndash, 33.33, p = 0.002). Conclusion: This study suggested that patients who sustained GLF and non-GLF were distinct groups of patients, and the height of fall did have an impact on mortality in patients of fall accidents. A significantly higher adjusted odds of mortality was found in the GLF group than in the non-GLF group after adjusting for age, sex, and comorbidities.

The preparation of boronic acid containing dendrimers is still a difficult task in dendrimer chemistry. In this investigation, an unanticipated hydrolysis product (4) was identified during the preparation of (G:2)-PAMAM-dendri-(4-phenyl boronic acid)14 (3) by acquiring its 1H NMR, 13C NMR, and UV–vis absorption spectra and IR spectra and comparing them with those of 4-hydroxylbenzoic acid (5). Furthermore, an Alizarin Red S staining analysis, ICP-MS, and 11B NMR spectrum indicated the lack of boronic acid in 4. Finally, treatment of 3 with hydrogen peroxide gave a product that was determined to be identical to dendrimer 4. By analyzing the formation of 4 under various conditions, the presence of numerous primary amines in a PAMAM dendrimer did accelerate the hydrolysis of peripheral boronic acid. This investigation revealed an apparent intrinsic problem that needs to be overcome during the preparation of boronic acid containing dendrimers and related boronic acid containing macromolecules.

Background/Introduction Ischemic preconditioning is a method in which brief periods of ischemia render tissues resistant to injury resulting from prolonged ischemia and reperfusion, so-called ischemia–reperfusion injury. Purpose To elucidate the possible protective role of ischemic preconditioning in rat livers with ischemia–reperfusion injury. Methods Rats were first allocated to either a sham control or an ischemic preconditioning group. On the following day, the rats from each group were administered either 30 minutes or 45 minutes hepatic ischemia. Next, rat livers were harvested for measuring proliferating cell nuclear antigen, heme oxygenase-1, inducible nitric oxide synthase, and heat shock protein 70 mRNA levels. Results Both proliferating cell nuclear antigen and hemeoxygenase-1 expression increased significantly after 45 minutes hepatic ischemia compared with those after 30 minutes hepatic ischemia, but they decreased significantly with ischemic preconditioning. However, ischemic preconditioning did not affect inducible nitric oxide synthase or heat shock protein 70 expression. Conclusion From the preliminary findings, further elucidation is warranted.

Background: Identification of malnutrition is especially important in severely injured patients, in whom hypermetabolism and protein catabolism following traumatic injury worsen their nutritional condition. The geriatric nutritional risk index (GNRI), based on serum albumin level and the current body weight/ideal body weight ratio, is useful for identifying patients with malnutrition in many clinical conditions. This study aimed to explore the association between admission GNRI and mortality outcomes of adult patients with polytrauma. Methods: From 1 January 2009 to 31 December 2019, a total of 348 adult patients with polytrauma, registered in the trauma database of a level I trauma center, were recognized and categorized into groups of death (n = 71) or survival (n = 277) and into four nutritional risk groups: a high-risk group (GNRI &lt, 82, n = 87), a moderate-risk group (GNRI 82 to &lt, 92, n = 144), a low-risk group (GNRI 92&ndash, 98, n = 59), and a no-risk group (GNRI &gt, 98, n = 58). Univariate and multivariate logistic regression analyses were used to identify the independent risk factors for mortality. The mortality outcomes of patients at various nutritional risks were compared to those of patients in the no-risk group. Results: The comparison between the death group (n = 71) and the survival group (n = 277) revealed that there was no significant difference in gender predominance, age, pre-existing comorbidities, injury mechanism, systolic blood pressure, and respiratory rate upon arrival at the emergency room. A significantly lower GNRI and Glasgow Coma Scale score but higher injury severity score (ISS) was observed in the death group than in the survival group. Multivariate logistic regression analysis revealed that Glasgow Coma Scale (GCS), odds ratio (OR), 0.88, 95% confidence interval (CI), 0.83&ndash, 0.95, p &lt, 0.001), ISS (OR, 1.07, 95% CI, 1.04&ndash, 1.11, 0.001), and GNRI (OR, 0.94, 95% CI, 0.91&ndash, 0.97, 0.001) were significant independent risk factors for mortality in these patients. The mortality rates for the high-risk, moderate-risk, low-risk, and no-risk groups were 34.5%, 20.1%, 8.5%, and 12.1%, respectively. Unlike patients in the moderate-risk and low-risk groups, patients in the high-risk group had a significantly higher death rate than that of those in the no-risk group. Conclusions: This study revealed that the GNRI may serve as a simple, promising screening tool to identify the high risk of malnutrition for mortality in adult patients with polytrauma.

Background: The purpose of this study was to profile the bacterium in the ascites and blood of patients with acute surgical abdomen by metagenome analysis. Methods: A total of 97 patients with acute surgical abdomen were included in this study. Accompanied with the standard culture procedures, ascites and blood samples were collected for metagenome analysis to measure the relative abundance of bacteria among groups of patients and between blood and ascites. Results: Metagenomic analysis identified 107 bacterial taxa from the ascites of patients. A principal component analysis (PCA) could separate the bacteria of ascites into roughly three groups: peptic ulcer, perforated or non-perforated appendicitis, and a group which included cholecystitis, small bowel lesion, and colon perforation. Significant correlation between the bacteria of blood and ascites was found in nine bacterial taxa both in blood and ascites with more than 500 sequence reads. However, the PCA failed to separate the variation in the bacteria of blood into different groups of patients, and the bacteria of metagenomic analysis is only partly in accordance with those isolated from a conventional culture method. Conclusion: This study indicated that the metagenome analysis can provide limited information regarding the bacteria in the ascites and blood of patients with acute surgical abdomen.

Selective glucose binding was identified through five generations of monoboronic acid-functionalized PAMAM dendrimers. The best selectivity obtained when using G3 dendrimers (1b) generated 71.1, 94.9, and 1309 times stronger binding than when using galactose, fructose, and lactose, respectively. Further experiments using dendrimer analogues and glucose derivatives suggested that two nearby monoboronic acids cooperatively bound one glucose.

A facile and effective synthesis for a wide variety of 4-arylidene-5-imidazolinone derivatives was developed. 4-Arylidene-5-oxazolinones were prepared by Erlenmeyer azlactone synthesis from N -acylglycines and arylaldehydes. The ring-opening reactions of the 4-arylidene-5-oxazolinones with primary amines afforded 2-acylamino-3-arylacrylamides in excellent yields. A new dehydrative cyclization of the 2-acylamino-3-arylacrylamides in pyridine under reflux furnished the corresponding 4-arylidene-5-imidazolinones in good yields.

Background: Breast cancer is a collection of molecularly and clinically distinct neoplastic disease. Recent research has shown that the gene expression in breast cancer can be useful when designing an optimal treatment plan and may also provide with prognostic information. The development of tissue microarrays (TMAs) has allowed for rapid immunohistochemical analysis of thousands of tissue samples in parallel with minimal damage to the original blocks. The aim of this study was to use TMAs to analyze the netrin-1 (NTN 1) status in patients with breast cancer with the hope of elucidating the possible relationship between NTN 1 expressions and breast cancer. Materials and Methods: Archival tissue specimens from 106 patients with primary invasive breast cancer were analyzed for NTN 1 expression using immunohistochemical staining with TMAs. Results were compared to clinicopathological data using multivariate analysis. Results: Tumor-node-metastasis stage was significantly related to the overall 5-year survival rate; however, NTN 1 expression was not significantly associated with overall 5-year survival. Conclusion: Immunohistochemical staining with TMAs was convenient and feasible to analyze the expression of NTN 1, in patients with breast cancer. Our preliminary results showed that NTN 1 expression had no significant prognostic value in breast cancer.

Many studies have shown that focal adhesion kinase (FAK) is a positive regulator of tumor progression and invasion. However, there is still very limited information about the role of FAK in breast cancer. Tissue microarrays (TMA) can analyze thousands of tissue samples in a parallel fashion with minimal damage to the origin block. This study was designed with the application of TMA to analyze the FAK status in breast cancer.Archival tissue specimens from 98 patients with primary invasive breast cancer were selected and FAK expression was analyzed by immunohistochemical staining with TMA. The data of primary tumor staging, age, estrogen receptor status, lymph node status, histological grading and TNM staging were also collected.There were four patients (4.0%) with grade 1 expression in FAK, 41 patients (41.8%) with grade 2 expression in FAK and 53 patients (54.2%) with grade 3 expression in FAK. There was no significant relationship between FAK expression and age, estrogen receptor status, histological grading, primary tumor staging, lymph node status and TNM stage. By multivariate analysis, the TNM stage was found to be significantly related to the overall five-year survival rate (p0.00001).Immunohistochemical staining with TMA is a convenient and feasible method. Unfortunately, our preliminary results fail to show meaningful prognostic value of FAK in breast cancer. A larger prospective study is warranted for further evaluation.

A new dehydrative cyclization method for the synthesis of the title compounds is developed for a broad scope of numerous commercially available starting compounds.

The development of tissue microarray (TMA) technology has provided the opportunity to perform analyses of tissue samples on a large scale in an uniform fashion. This study was designed with the use of TMA to explore the Yes-associated protein (YAP) status in breast cancer.YAP expression in tumor and tumor-free samples from 94 patients with primary breast cancer was analyzed by TMA. The clinicopathological data for age, estrogen receptor status, histological grading and TNM staging were also collected.There were 29 patients (30.8%) with 1(+) expression, in YAP, 59 patients (62.8%) with 2(+) expression and 6 (6.4%) with 3(+) expression. There was no significant relationship between YAP expression and the other clinicopathological variables. By multivariate analysis, YAP expression failed to produce any significant relationship with the overall survival rate.YAP expression is not an independent prognostic factor in patients with breast cancer.

The benefit of tissue microarray (TMA) is its capability to analyse large numbers of tissue samples in a uniform fashion. This study was designed to evaluate the capability of TMA for analyzing the status of death-associated protein kinase 1 (DAPK1) in breast cancer patient and to explore its potential in the management of breast cancer.Over a 60-month period, tissue specimens of 99 patients with primary invasive breast cancer were selected. Tissue microarray (TMA) was applied to detect the DAPK1 expression. The data for the other clinicopathologic variables, including age, histological grading, estrogen receptor status and TNM staging were also recorded.Tumor in 11 patients (11.1%) scored 1 for DAPK1 expression, 55 patients (55.6%) scored 2 and 33 (33.3%) scored 3. We found no obvious link between DAPK1 expression and age, histologic grading, primary tumor staging, lymph node status, estrogen receptor and TNM stage. TNM staging was found to be significantly linked to the overall five-year survival rate through multivariate analysis.DAPK1 expression did not show any meaningful value in predicting outcome for patients with breast cancer.

A concise solid-phase synthesis of inverse poly(amidoamine) dendrons was developed. Upon introduction of AB2-type monomers, each dendron generation was constructed via one reaction. G2 to G5 dendrons were constructed in a peptide synthesizer in 93%, 89%, 82%, and 78% yields, respectively, within 5 days.