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Jin Hong,1 Xiaosong Chen,1 Weiqi Gao,1 Siji Zhu,1 Jiayi Wu,1 Ou Huang,1 Jianrong He,1 Li Zhu,1 Weiguo Chen,1 Yafen Li,1 Xiaochun Fei,2 Lin Lin,3 Kunwei Shen11Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 3Department of Clinical Laboratory, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, People’s Republic of ChinaBackground: Immune responses play an important role in the development of breast cancer. Trastuzumab can activate antibody-dependent cellular cytotoxicity (ADCC) in human epidermal growth factor receptor-2 (HER-2)-positive breast cancer. Many studies have demonstrated that inflammatory markers, such as the neutrophil-to-lymphocyte ratio (NLR) and absolute lymphocyte count (ALC), are associated with prognosis in breast cancer. The aim of this study was to explore whether preoperative NLR, ALC or the absolute neutrophil count (ANC) is associated with prognosis in HER-2-positive breast cancer patients who received adjuvant trastuzumab.Patients and methods: Three hundred sixty-seven female patients with HER-2-positive invasive breast cancer who were treated with one-year adjuvant trastuzumab were analysed in this retrospective study. Preoperative haematological parameters, clinicopathological data and survival data were obtained. The cut-off points for ALC, ANC and NLR were based on the median values. Disease-free survival (DFS) and Overall survival (OS) were analysed by the Kaplan-Meier method. Multivariable Cox regression was used to determine the independent prognostic significance of ALC, ANC and NLR.Results: Survival analysis revealed that the 3-year DFS in patients with high ALC was 89.0%, which was significantly worse than 95.0% in patients with low ALC (p=0.014). Kaplan-Meier analysis also showed that patients with low NLR had a poorer 3-year DFS than patients with high NLR (89.7% vs 94.0%, respectively; p=0.047). Multivariate analysis showed that ALC was an independent prognostic factor for DFS (HR=2.723; 95% CI=1.211–6.122; p=0.015). Neither ANC, ALC nor NLR could predict OS independently.Conclusion: In HER-2-positive breast cancer patients who were treated with adjuvant trastuzumab, a high ALC is significantly associated with a poor DFS.Keywords: breast cancer, HER-2 positive, trastuzumab, absolute lymphocyte count, neutrophil-to-lymphocyte ratio

This study explored the low-carbon operation and control strategy of wastewater treatment plants based on cost reduction and efficiency improvement, with a South China plant as a case study. Factors influencing phosphorus removal, including sludge age, concentration, dissolved oxygen, reflux ratio, and chemical dosing location, were analyzed. Optimal operation parameters such as sludge concentration, air/water ratio, and dissolved oxygen level were established based on influent characteristics across seasons. Implementation of these low-carbon strategies ensures the plant's effluent quality remained within standards, exhibiting a stable and decreasing trend. Meanwhile, chemical consumption for phosphorus removal decreasesd by approximately 41%, the electricity consumption per ton of treated wastewater decreased by 26.5%, resulting in a reduction of indirect carbon emissions by 0.18 kg/t(calculated by CO2,eq), which had achieved energy conservation, emission reduction, and clean production.

OBJECTIVE: To uncover the function of LINC00461 in regulating cellular behaviors of gastric cancer (GC) via targeting LSD1. PATIENTS AND METHODS: LINC00461 level in GC tissues with different tumor node metastasis (TNM) staging and lymphatic metastasis statues was determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). In vitro influences of LINC00461 on proliferative and apoptotic rates were evaluated in AGS and SGC-7901 cells. The interaction between LINC00461 and LSD1 was explored by RNA immunoprecipitation (RIP) assay and qRT-PCR. Finally, the potential role of LSD1 in the proliferative ability of GC cells mediated by LINC00461 was assessed. RESULTS: LINC00461 level was higher in GC tissues relative to matched control ones. It was positively correlated to TNM staging and lymphatic metastasis of GC. Knockdown of LINC00461 markedly attenuated viability and the proliferative ability of AGS and SGC-7901 cells, but induced apoptosis. RIP assay demonstrated the interaction between LINC00461 and LSD1. Moreover, LSD1 could reverse the regulatory effect of LINC00461 on the proliferative ability of GC cells. CONCLUSIONS: LINC00461 is upregulated in GC, which is positively related to TNM staging and lymphatic metastasis. LINC00461 mediates proliferation and apoptosis of GC cells, thereafter aggravating the progression of GC. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To uncover the biological effect of long non-coding RNA (lncRNA) PAPAS on the progression of gastric cancer (GC) by mediating microRNA-188-5p (miRNA- 188-5p) level. PATIENTS AND METHODS: The relative level of PAPAS was determined in GC tissues and cell lines by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The Kaplan- Meier method was introduced to assess the prognostic potential of PAPAS in the overall survival of GC patients. Regulatory effects of PAPAS on proliferative, migratory, and invasive abilities of HGC-27 and AGS cells were detected by cell counting kit-8 (CCK-8), transwell, and wound closure assay, respectively. Subsequently, the binding relation between PAPAS and miRNA-188-5p was verified by the Dual-Luciferase reporter gene assay. Correlation between expression levels of PAPAS and miRNA-188-5p in GC tissues was explored. Finally, rescue experiments were conducted to uncover the role of PAPAS/miRNA-188-5p axis in the progression of GC. RESULTS: PAPAS was upregulated in GC tissues and cell lines compared to controls. GC patients expressing a high level of PAPAS suffered worse prognosis relative to those with low level. The silence of PAPAS remarkably attenuated proliferative, migratory, and invasive abilities of HGC-27 cells. Overexpression of PAPAS in AGS cells obtained the opposite trends. MiRNA-188- 5p was the direct target of PAPAS, which was negatively regulated by PAPAS. MiRNA-188-5p was able to reverse the regulatory effects of PA-PAS on proliferative, migratory, and invasive abilities of GC cells. CONCLUSIONS: LncRNA PAPAS is upregulated in GC and closely related to lymphatic metastasis, distant metastasis, and poor prognosis of GC patients. PAPAS aggravate the malignant progression of GC by negatively regulating the miRNA-188-5p level. [ABSTRACT FROM AUTHOR]

Objectives: Endometriosis is a potential pre-malignant gynecological condition harboring multiple gene mutations in the endometriotic lesions. Evidence has implicated the possibility that caspase recruitment domain family member 14 (CARD14) mutations might exist in ovarian endometriosis. It is questioned whether ovarian endometriosis harbors CARD14 mutations. Materials and Methods: The authors recruited and analyzed a cohort of 101 ovarian endometriosis samples for the presence of CARD14 mutations via sequenced the coding and intron/exon boundary regions of the CARD14 gene. Results: A novel heterozygous somatic CARD14 mutation, p.R470C (c.1408C>T), was identified in two out of 101 (2.0%) endometriotic lesions. The mutated samples were 30- and 31-years-old and both had a history of childbirth. No CARD14 mutations were detected in the remaining 99 samples with ovarian endometriosis. Protein structure modeling results showed CARD14 p.R470C mutation resulted in protein structural changes. These combined results implicated that this mutation might be damaging. However, no association was observed between the main clinical features and CARD14 mutations in this sample cohort. Conclusion: The authors identified a potential damaging CARD14 somatic mutation in 2/101 (2.0%) endometriotic lesions with ovarian endometriosis for the first time, and this mutation might play an active role in the development of ovarian endometriosis. [ABSTRACT FROM AUTHOR]

Objective: To analyze the clinicopathologic feature of Stage I A1 squamous carcinoma of the cervix (SCC) and to explore the outcome of different surgical methods. Materials and Methods: Clinicopathological data of 346 cases with Stage I A1 SCC diagnosed between November 2 nd, 1995 and December 31 st, 2011 were reviewed and analyzed. Results: As major diagnostic method, 44.5% (154/346) patients accepted cold knife conization (CKC), while 58.1% (201/346) patient took total hysterectomy (TH) as their final surgical methods. The trend in treatment methods from 1995 to 2011 revealed that increasing cases were treated with CKC, modified radical hysterectomy (MRH) obviously reduced, while the proportion treated by TH remained unchanged. Due to a small number of cases receiving vaginal trachelectomy (VT) and radical trachelectomy (RT), the authors did not find any obvious changes. Prognosis: The overall recurrence rate was 1.2% (4/346). The overall survival rates for CKC, VT, TH, MRH, and RT were 100%, 100%, 98.2%, 100%, and 100%, and the difference was not statistically significant (p = 0.819). The incidence rate of LVSI was 4.9% (17/346), the overall survival rates for patients with LVSI and without LVSI were 99.3% and 93.3%, respectively, and there was statistical difference between them (p = 0.003). Univariate analysis showed that only LVSI was an important predictor for survival (p = 0.030). Conclusions: the treatments for Stage I A1 SCC are becoming more conservative, and individualized therapy and more frequent surveillance should be administrated to those patients with LVSI. [ABSTRACT FROM AUTHOR]

The article presents a study aimed at developing fuzzy-based simulation method (FBSM) for modelling hydrological processes under uncertainty in Tarim River Basin in China. It says that the FBSM method was developed through integrating fuzzy vertex analysis technique, distributed hydrological model and factorial analysis. Results showed that the uncertainties have impacts on groundwater flow such as the effects of hydraulic conductivity and leakage coefficient on modeling outputs.

A correction is presented to the article LncRNA PAPAS aggravates the progression of gastric cancer through regulating miRNA-188-5.

Current soil stabilization methods are often limited by durability and leaching issues and do not always offer sustainable treatments. This research explores the use of geopolymers to stabilize clays in the North Texas area. In recent years, geopolymer has received much attention as an eco-friendly and sustainable alternative to conventional chemical additives, since it can be processed at room temperature from aqueous solutions by utilizing waste materials and/or abounded natural sources. Two subgrade soils from North Texas were treated with GP mix at a ratio of 8 wt% dry GP to dry soil. GP is shown to reduce swelling and shrinkage potential of soil considerably while an increase in unconfined compressive strength is observed as well. Therefore, further studies are recommended to understand the mechanism of GP and soil bonding resulting in said changes.

Abstract Background As part of its ongoing healthcare reform, the Hong Kong Government introduced a voucher scheme, intended for encouraging older patients to use primary healthcare services in the private sector, thereby, reducing burden on the overwhelmed public sector. The voucher program is also considered one of the strategies to further develop the public private partnership in healthcare, a policy direction of high political priority as indicated in the Chief Executive Policy Address in 2008-09. This study assessed whether the voucher scheme, as implemented so far, has reached its intended goals, and how it might be further improved in the context of public-private partnership. Methods This was a cross-sectional study using structured questionnaires by face-to-face interviews with older people aged 70 or above in Hong Kong, the target group of the demand-side voucher program. Results 71.2% of 1,026 older people were aware of the new voucher scheme but only 35.0% had ever used it. The majority of the older people used the vouchers for acute curative services in the private sector (82.4%) and spent less on preventive services. Despite the provision of vouchers valued US$30 per year as an incentive to encourage the use of private primary care services, after 12-months of implementation, 66.2% of all respondents agreed with the statement that "the voucher scheme does not change their health seeking behaviours on seeing public or private healthcare professionals". The most common reasons for no change in their behaviours included "I am used to seeing doctors in the public system" and "The amount of the subsidy is too low". Those who usually used a mix of public and private doctors and those with better self-reported health condition compared to last year were more likely to perceive a change in their own health seeking behaviours. Conclusions Our study showed that despite a reasonably high awareness of the voucher scheme, its usage was low. The voucher alone was not enough to realize the government's policy of greater use of the private primary care services. Greater publicity and more variety of media promotion would increase awareness but the effectiveness of vouchers in changing older people's behaviour needs to be revisited. Designating vouchers for use of preventive services with evidence-based practice could be considered. In addition to the demand-side subsidies, improving transparency and comparability of private services against the public sector might be necessary.

Abstract Background Sentinel lymph node (SLN) biopsy has been used to assess patients with papillary thyroid carcinoma (PTC). To achieve its full potential the rate of SLN identification must be as close to 100 percent as possible. In the present study we compared the combination of preoperative lymphoscintigraphy scanning by sulfur colloid labeled with 99 m Technetium, gamma-probe guided surgery, and methylene blue with methylene blue, alone, for sentinel node identification in younger women with unilateral low-risk PTC. Methods From January 2004 to January 2007, 90 female patients, ages 23 to 44 (mean = 35), with unilateral low-risk PTC (T1-2N0M0) were prospectively studied. Mean tumor size was 1.3 cm (range, 0.8-3.7 cm). All patients underwent unilateral modified neck dissection. Prior to surgery, patients had, by random assignment, identification and biopsy of SLNs by methylene blue, alone (Group 1), or by sulfur colloid labeled with 99 m Technetium, gamma-probe guided surgery and methylene blue (Group 2). Results In the methylene blue group, SLNs were identified in 39 of 45 patients (86.7%). Of the 39 patients, 28 (71.8%) had positive cervical lymph nodes (pN+), and 21 patients (53.8%) had pSLN+. In 7 of the 28 pN+ patients (25%), metastases were also detected in non-SLN, thus giving a false-negative rate (FNR of 38.9% (7/18), a negative predictive value (NPV) of 61.1% (11/18), and an accuracy of 82.1% (32/39). In the combined technique group, the identification rate (IR) of SLN was 100% (45/45). Of the 45 patients, 27 (60.0%) had pN+, 24 (53.3%) had pSLN+. There was a FNR of 14.3% (3/21), a NPV of 85.7% (18/21), and an accuracy of 93.3% (42/45). The combined techniques group was significantly superior to the methylene blue group in IR (p = 0.035). There were no significant differences between two groups in sensitivity, specificity, NPV, or accuracy. Location of pN+ (55 patients) in 84 patients was: level I and V, no patients; level II, 1 patient (1.2%); level III, 6 patients (7.2%); level III and IV, 8 patients (9.5%); level IV, alone, 8 patients (9.5%); level VI, 32 patients (38.1%). In all 90 patients, IR of SLN was 93.3%, FNR, 25.6%, NPV, 74.4%, and accuracy rate, 88.1 percent. Conclusions Compared to a single technique, there was a significantly higher SLN identification rate for the combined technique in younger female with ipsilateral, low-risk PTC (T1-2N0M0). Thus, a combined SLN biopsy technique seems to more accurately stage lymph nodes, with better identification of SLN located out of the central compartment. Regardless of the procedure used, the high FNR renders the current SLN techniques unsuitable for routine practice. Based on these results, prophylactic node dissection of level VI might be considered because 38.1% of our patients had such node metastases.

Abstract Background This study is a retrospective evaluation of the efficacy of neoadjuvant chemotherapy (NC) with a vinorelbine (V) and epirubicin (E) intravenous combination regimen and is aimed at identification of predictive markers for the long-term outcome in noninflammatory locally advanced breast cancer (NLABC). Methods One-hundred-and-nineteen patients with NLABC were identified from September 2001 to May 2006. Analysis was performed in March 2008, with a median follow-up of 63.4 months (range, 9-76 months). All patients were diagnosed with invasive breast cancer using 14 G core needle biopsy and treated with three cycles of VE before surgery. Local-regional radiotherapy was offered to all patients after the completion of chemotherapy followed by hormonal therapy according to hormone receptor status. Tissue sections cut from formalin-fixed paraffin-embedded blocks from biopsy specimens and postoperative tumor tissues were stained for the presence of estrogen receptor (ER), progesterone receptor (PgR), HER-2 (human epidermal growth factor receptor-2), and MIB-1(Ki-67). Results Patients characteristics were median age 52 years (range: 25-70 years); clinical TNM stage, stage IIB (n = 32), stage IIIA (n = 56), stage IIIB (n = 22) and stage IIIC (n = 9). All patients were evaluable for response: clinically complete response was documented in 27 patients (22.7%); 78 (65.6%) obtained partial response; stable disease was observed in 13 (10.9%); 1 patient (0.8%) had progressive disease. Pathological complete response was found in 22 cases (18.5%). Seventy-five patients were alive with no recurrence after a median follow-up of 63.4 months, the 5-year rates for disease-free survival and overall survival were 58.7% and 71.3%, respectively, after the start of NC. On multivariate analysis, the independent variables associated with increased risk of relapse and death were high pre-Ki-67(p = 0.012, p = 0.017, respectively), high post-Ki-67 expression (p = 0.045, p = 0.001, respectively), and non-pCR (p = 0.034, p = 0.027, respectively). A significantly increased risk of death was associated with lack of pre-ER expression (p = 0.002). Among patients with non-pCR, those with a pathological response at the tumor site with special involvement (i.e. skin, vessel and more than one quadrant) were at a higher risk of disease relapse and death (p < 0.001, p = 0.001, respectively). Conclusion This study suggests the promising use of a VE regimen as NC for Chinese NLABC after a median follow-up of 63.4 months. Pathological response in the tumor site, pre-Ki-67 and post-Ki-67 expression, and pre-ER expression were the important variables that predicted long-term outcome. Patients with pathological special involvement at the primary site after NC had the lowest survival rates.