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Background: Internal jugular vein (IJV) and axillary vein/subclavian vein (AxV/SCV) are commonly used for implantable venous access port (IVAP) implantation in breast cancer (BC) patients with chemotherapy. Previous studies focused on complications between these different approaches and ignored patient comfort. In this study, we aim to compare patient comfort between IJV and AxV/SCV approaches, as well as surgery duration and complications., Methods: This is a single-center prospective randomized controlled clinical trial. A total of 200 patients diagnosed with invasive BC will be enrolled in this study. After signing written informed consent, patients schedule to undergo IVAP implantation will be randomized at a 1:1 ratio to receive central venous catheters (CVC) with either IJV or AxV/SCV approaches. Baseline as well as demographic data and procedure time of port implantation will be recorded. All patients will receive assessment of comfort with a comfort scale table at days 1, 2 and 7 after implantation surgery. Patients will be followed up and complications will be recorded until devices are removed at the end of the treatment period, or in case of complications. Patient comfort, procedure time of implantation and complications will be compared and analyzed between these two arms., Discussion: To the best of our knowledge, this is the first study to compare patient comfort as primary outcome measure between IJV and AxV/SCV puncture. This study will further confirm the benefits of ultrasound guidance and may provide a better choice of IVAP implantation for BC patients., Trial Registration: This study has been registered at Chinese Clinical Trial Registry (ChiCTR, www. chictr.org.cn) and Chinese Ethics Committee of Registering Clinical Trials (No. ChiCTR2000034986).

The role of serum lactate dehydrogenase (LDH) on the clinical outcomes of non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitors (TKIs) treatment remained to be elucidated. Therefore, we did this meta-analysis. We searched databases including PubMed, EMBASE, and Cochrane Library till to June, 2017. The relationships between the LDH levels and overall survival (OS) and progression free survival (PFS) were assessed by calculating hazard ratios (HRs) and 95% confidence intervals (CIs). The association between the LDH levels and disease control rate (DCR) was calculated by odds ratio (OR) and 95% CI. Seven studies were included in the meta-analysis. As for DCR, the result from this meta-analysis was not positive (OR=0.71; 95% CI 0.21 - 2.37; P=0.57). As for PFS, the result of the meta-analysis indicated that elevated LDH was significantly associated with shorter PFS (HR=1.88; 95%CI, 1.37-2.59). When studies were stratified by ethnicity, significant association was also observed in Asian group (HR=2.36; 95%CI, 1.57-3.55). As for OS, patients with high levels of LDH showed significantly shorter OS (HR=2.44; 95%CI, 1.84-3.23). In the subgroup by race, significant associations were found in Asian group (HR=2.62; 95%CI, 1.61-4.26) and Caucasian population (HR=2.36; 95%CI, 1.66-3.34). In conclusion, this meta-analysis suggested that elevated LDH level was associated with the poor PFS and OS of NSCLC patients receiving EGFR-TKIs treatment.

Introduction: Recently, a genome-wide association study (GWAS) indicated that rs7216389 polymorphism on chromosome 17q21 was associated with paediatric asthma risk. However, the results remained controversial. Therefore, a meta-analysis was performed., Evidence Acquisition: A comprehensive literature retrieve was performed on PubMed, Embase and Science Direct databases up to Feb 20, 2016. The strength of association between 17q21 locus rs7216389 polymorphism and pediatric asthma risk was assessed by computing odds ratio (OR) with its corresponding 95% confidence interval (CI)., Evidence Synthesis: A total of 10 studies with 7797 cases and 38757 controls were included. A statistically significant association of rs7216389 polymorphism and pediatric asthma risk was found (OR=1.41, 95%CI=1.34-1.49, P<0.00001). Furthermore, both Caucasians (OR=1.41, 95%CI=1.33-1.49, P<0.00001) and Asians (OR=1.43, 95%CI=1.25-1.63, P<0.00001) with rs7216389 polymorphism showed significant association, respectively. A significantly increased susceptibility was identified in atopic asthma (OR=1.45, 95%CI=1.22-1.72, P<0.00001). In the stratification analysis by study design, both case-control studies (OR=1.40, 95%CI=1.33-1.48, P<0.00001) and cohort studies (OR=2.05, 95%CI=1.32-3.17, P=0.001) showed significant association, respectively., Conclusions: In conclusion, this meta-analysis suggests that 17q21 locus rs7216389 polymorphism was significantly associated with paediatric asthma risk.

Some studies assessed the association between lncRNA taurine-upregulated gene 1 (TUG1) and the survival in cancer. However, the results were inconclusive.  Therefore, we performed a meta-analysis to determine this association. We used the following electronic databases to search for eligible literature: PubMed, Embase, Chinese National Knowledge Infrastructure (CNKI) and Wanfang. We used ORs and 95% CIs to measure the association between TUG1 and the survival of cancer. There was no significant association between TUG1 and OS of cancer (HR=1.26, 95% CI=0.97-1.64). In the subgroup analysis by cancer type, significant association could be find in osteosarcoma (HR=1.72, 95% CI=1.27-2.32) and digestive system's tumors (HR=1.66, 95% CI=1.04-2.66). In conclusion, this meta-analysis study indicated that TUG1 might associate with the OS of osteosarcoma and digestive system's tumors.

Some studies found that there was a significant association between asthma and the risk of lung cancer. However, the results are inconclusive. Therefore, we performed a meta-analysis. We searched the electronic databases for all relevant articles. Odds ratio (OR) with 95% confidence interval (CI) were used to calculate the strength of the association between asthma and lung cancer risk. Asthma was significantly associated with the increased risk of lung cancer (OR = 1.44; 95% CI 1.31-1.59; P < 0.00001; I2 = 83%). Additionally, asthma patients without smoking also had the increased lung cancer risk. In the subgroup analysis of race and gender, Caucasians, Asians, male, and female patients with asthma showed the increased risk of lung cancer. However, asthma was not significantly associated with lung adenocarcinoma risk. In the stratified analysis by asthma definition, significant associations were found between asthma and lung cancer in self-reported subgroup, questionnaire subgroup, and register databases subgroup. However, no significant association was observed in physician-diagnosed asthma subgroup. In conclusion, this meta-analysis suggested that asthma might be significantly associated with lung cancer risk.

Some studies investigated the association between ADD1 rs4963 polymorphism and hypertension risk. However, the results remained inconclusive. Thus, we performed a meta-analysis. Published reports were searched in PubMed and Google Scholar. The strength of association was assessed by calculating odds ratios (OR) and 95% confidence interval (CI). Twelve studies with 5097 cases and 5937 controls were conducted in this study. Individuals with ADD1 rs4963 polymorphism showed an increased hypertension risk (OR = 1.21; 95%CI, 1.11-1.33; P &lt; 0.0001). Subgroup analyses were performed according to country and age. The results showed that Chinese with ADD1 rs4963 polymorphism showed an increased hypertension risk (OR = 1.28; 95%CI, 1.09-1.51; P = 0.003). However, subjects in Japan and India did not have increased hypertension risk. In the subgroup analysis by age, older subjects, but not younger subjects, with ADD1 rs4963 polymorphism showed an increased hypertension risk (OR = 1.19; 95%CI, 1.07-1.32; P = 0.001). In conclusion, this meta-analysis suggested that ADD1 rs4963 polymorphism might be associated with increased hypertension risk.

Engineered antibody fragments often contain natural or synthetic linkers joining the antigen-binding domain and multimerization regions, and the roles of these linkers have largely been overlooked. To investigate linker effects on structural properties and functionality, six bivalent cytotoxic antibody fragments with of linkers of varying flexibility and length were constructed: (1) 10-AA mouse IgG3 upper hinge region, (2) 20-AA mouse IgG3 upper hinge region repeat, (3) 10-AA glycine and serine linker, (4) 20-AA glycine and serine linker repeat, (5) 21-AA artificial linker, and (6) no-linker control. Interestingly, a higher cytotoxicity was observed for fragments bearing the rigid short linkers compared to the flexible longer linkers. More importantly, amino acid composition related to the rigidity/flexibility was found to be of greater importance upon cytotoxicity than linker length alone. To further study the structure-function relationship, molecular modelling and dynamics simulation were exploited. Resultantly, the rigid mouse IgG3 upper hinge region was predicted to enhance structural stability of the protein during the equilibrium state, indicating the improved cytotoxicity over other combinations of fragments. This prediction was validated by measuring the thermal stability of the mouse IgG3 upper hinge as compared to the artificial linker, and shown to have a higher melting temperature which coincides with a higher structural stability. Our findings clearly suggest that appropriate linker design is required for enhancing the structural stability and functionality of engineered antibody fragments., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Remodeling of the extracellular matrix has been implicated in ovarian cancer. To quantitate the remodeling, we implement a form of texture analysis to delineate the collagen fibrillar morphology observed in second harmonic generation microscopy images of human normal and high grade malignant ovarian tissues. In the learning stage, a dictionary of “textons”—frequently occurring texture features that are identified by measuring the image response to a filter bank of various shapes, sizes, and orientations—is created. By calculating a representative model based on the texton distribution for each tissue type using a training set of respective second harmonic generation images, we then perform classification between images of normal and high grade malignant ovarian tissues. By optimizing the number of textons and nearest neighbors, we achieved classification accuracy up to 97% based on the area under receiver operating characteristic curves (true positives versus false positives). The local analysis algorithm is a more general method to probe rapidly changing fibrillar morphologies than global analyses such as FFT. It is also more versatile than other texture approaches as the filter bank can be highly tailored to specific applications (e.g., different disease states) by creating customized libraries based on common image features.

Patients with idiopathic fibrosis (IPF) have poor long-term survival as there are limited diagnostic/prognostic tools or successful therapies. Remodeling of the extracellular matrix (ECM) has been implicated in IPF progression; however, the structural consequences on the collagen architecture have not received considerable attention. Here, we demonstrate that second harmonic generation (SHG) and multiphoton fluorescence microscopy can quantitatively differentiate normal and IPF human tissues. For SHG analysis, we developed a classifier based on wavelet transforms, principle component analysis, and a K-nearest-neighbor algorithm to classify the specific alterations of the collagen structure observed in IPF tissues. The resulting ROC curves obtained by varying the numbers of principal components and nearest neighbors yielded accuracies of >95%. In contrast, simpler metrics based on SHG intensity and collagen coverage in the image provided little or no discrimination. We also characterized the change in the elastin/collagen balance by simultaneously measuring the elastin autofluorescence and SHG intensities and found that the IPF tissues were less elastic relative to collagen. This is consistent with known mechanical consequences of the disease. Understanding ECM remodeling in IPF via nonlinear optical microscopy may enhance our ability to differentiate patients with rapid and slow progression and, thus, provide better prognostic information.

InVO4 has attracted much attention as an anode material due to its high theoretical capacity. However, the effect of preparation methods and conditions on morphology and energy storage characteristic has not been extensively investigated and will be explored in this project. InVO4 anode material was prepared using five different preparation methods: solid state, urea combustion, precipitation, ball-milling, and polymer precursor methods. Morphology and physical properties of InVO4 were then analyzed using X-ray diffraction (XRD), scanning electron microscope (SEM), and Brunauer-Emmett-Teller (BET) surface area method. XRD patterns showed that orthorhombic phased InVO4 was synthesized. Small amounts of impurities were observed in methods II, III, and V using XRD patterns. BET surface area ranged from 0.49 to 9.28 m(2) g(-1). SEM images showed slight differences in the InVO4 nanosized crystalline structures with respect to preparation methods and conditions. Energy storage studies showed that, among all the preparation methods, the urea combustion method produced the best electrochemical results, with negligible capacity fading between the 2nd and 50th cycles and high capacity of 1241 mA h g(-1) at the end of the 20th cycle, close to the theoretical capacity value. Precipitation method also showed good performance, with capacity fading (14%) and capacity of 1002 mA h g(-1) at the 20th cycle. Cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) was then used to determine the reaction mechanisms of InVO4.

Objective: To preliminarily analyze key factors influencing curative effect through clinical observations of acupoint application for "treatment of winter disease in summer" used to prevent and treat bronchial asthma in children., Methods: In an observational study and prospective cohort study, we observed children in remission of asthma at three class III grade A TCM hospitals in Liaoning, Hubei, and Chengdu., Results: A total of 609 children conformed to diagnostic and inclusive standards for remission of bronchial asthma. Through follow-up visits, we observed their skin reactions and the time and chance of treatment with different therapies in the three hospitals; we also compared and analyzed different drugs, acupoints, and preparations. We found that the key Chinese drugs were Bai Jie Zi (Semen Sinapis Albae) and Yian Hu Suo (Rhizoma Corydalis); the key acupoints were Feishu (BL 13), Gaohuang (BL 43), Dingchuan (EX-B1), Tiantu (CV 22), and Shanzhong (CV 17); and the best preparation was a mixture of drugs, ginger juice, and musk. Acupoint application was practiced on the hottest days of summer and the coldest days of winter for 0.5 to 2 h with the lowest rate of asthma relapse., Conclusions: The present data analysis shows that the curative effect of acupoint application for "treatment of winter disease in summer" may be influenced by recipes of Chinese drugs, preparations, prescriptions of acupoints, chance, time, and skin reactions. A curative effect is the result of the comprehensive action of these factors.

Based on ZhangShi YiTong written by ZHANG Lu of Qing dynasty, and the record that external application of Baijiezi (seeds of Brassica Alba) for treating asthma of cold syndrome, retrospective study is conducted to modern literature of treating winter diseases in summer with acupoint sticking therapy for preventing and treating chronic cough and asthma. Learning from thoughts and methods of evidence-based medicine, and according to subject characteristics of TCM and acupuncture, acupoints and point-selecting discipline of prescription for preventing and treating chronic cough and asthma in summer with acupoint sticking are analyzed. The results show that the top ten common acupoints used for acupoint sticking therapy of treating winter diseases in summer are Feishu (BL 13), Dingchuan (EX-B 1), Xinshu (BL 15), Geshu (BL 17), Danzhong (CV 17), Shenshu (BL 23), Gaohuang (BL 43), Dazhui (GV 14), Pishu (BL 20), Tiantu (CV 22), most of which belong to the Bladder Meridian of Foot-Taiyang, Conception Vessel and Governor Vessel or extra-meridian points. It refers that the core acupoints of acupoint sticking therapy are Feishu (BL 13), Dingchuan (EX-B 1), Xinshu (BL 15), Geshu (BL 17), Danzhong (CV 17), and adjunct points can be selected by syndrome, disease different stage, disease or symptoms.

Through combing the academic development of acupuncture in recent ten years, objectively reflects the real development status of acupuncture subject on these aspects sucl as basis, clinic, equipment, teaching and standardization, etc., shows the scientific and technological achievements and the highlights of the acupuncture academic development, analyzes the bottleneck and dilemma of the acupuncture academic development. It is indicated that there are several problems existed in acupuncture researche at present, such as the scale and the input of the acupuncture theory research are not enough, the basic research and clinical application is disjointed, the correlation between the acupoints and viscera need more systematic and further researches, the design level of clinical research on acupoints' main indications should be improved. From now on we should follow the inherent rule of the traditional theory of Chinese medicine and the way of integrated thinking, explore the new rule of acupuncture academic development, in order to fit the new historical period, and comprehensively promote the sustainable and coordinated development of acupuncture science.

Based on the literatures about the optimized effectiveness of the acupoint sticking therapy for diseases which are attacked in winter but are treated in summer, the main constituent elements of plaster, acupoints, the dose and the application time are reviewed and analyzed. It is suggested that the stepwise procedures are adoped to accumulate clinical evidence, standardize the technique instructions based on the clinical evidences, and perform high quality clinical trials.

We present photoelectron measurements from argon ionization at 10(19) W/cm(2). Photoelectrons with energies above 400 keV, including a 1.2 MeV cutoff, are in quantitative agreement with a semiclassical, relativistic 3D ionization model that includes a nonparaxial laser field. L-shell photoelectrons have energies and momentum dominated by the field, including the acceleration out of the focus. Yields and angular distributions at 60 keV come from valence shell ionization by strong fields where rescattering and atomic processes determine photoelectron final states.