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Abstract For breast cancer patients with physical exam node negative but radiological finding node abnormal (cN0/rNa), the NCCN and ASCO guidelines recommend sentinel lymph node biopsy (SLNB) as the first-line axillary staging. However, patients who undergo surgery firstly may be upstaged to pathological II–III status, and these patients happen to be the adaptive population of neoadjuvant therapy (NAT). There is no consensus on the optimal management of cN0/rNa patients. The aim is to explore the optimal management strategy of these patients. We performed a retrospective real-world study of 1414 cN0/rNa patients from June 2014 to October 2022. There were 1003 patients underwent surgery first and 411 patients underwent surgery after NAT. We analyzed the real-world conditions of these patients, compared axilla tumor burden between these two groups. In addition, we compared benefit ratio of axillary surgery and regional nodal irradiation (RNI) de-escalation under the two strategies. Among 1003 patients underwent surgery first, the positive and negative rates of fine needle aspiration (FNA) were 18.5% and 81.5%, respectively. There were 66.1% had ≤ 2 lymph nodes+. There were 40.8% of FNA+ patients could be exempted from ALND underwent surgery first. In 411 patients underwent surgery after NAT, the FNA positive and negative rates were 60.8% and 49.2%, respectively. There were 54.4% of FNA+ patients achieved axilla pathologic complete response (apCR) and could omit ALND after NAT. The apCR was 67.3% in HER2+/TNBC subtypes. According to the NSABP-B51 trial, there were 0 and 54.4% of FNA+ patients could omit RNI among surgery first and after NAT, respectively. Among 1–2 sentinel lymph node (SLN)-positive patients underwent surgery first, with a median follow-up 49 months, there was no difference of survival benefit between SLNB-only and SLNB-ALND. Compared with 1–2 SLN+ patients without RNI, RNI could bring better invasive disease-free survival (97.38% vs. 89.36%, P = 0.046) and breast cancer special survival (100% vs. 94.68%, P = 0.020). It is safe to perform SLNB omitting ALND when detected 1–2 positive SLNs in cN0/rNa patients. Patients with HER2+/TNBC subtypes underwent surgery after NAT had more chance to benefit from dual de-escalation, including axillary surgery and RNI de-escalation.

PurposeThe purpose of this study was to provide advice for the indication of regional nodal irradiation (RNI) in patients with one to two positive sentinel lymph nodes (SLNs) without axillary lymph node dissection (ALND).MethodsWe conducted a retrospective study in Shandong Cancer Hospital, Fudan University Shanghai Cancer Center, and West China Hospital. Logistic analysis was performed in order to explore the influencing factors of positive non-SLNs (NSLNs) and >3 positive nodes among patients with one to two SLNs+. Then, nomograms were constructed.ResultsBetween May 2010 and 2020, among the 2,845 patients with one to two SLNs+ undergoing ALND (1,992 patients in the training set and 853 patients in the validation set), there were 34.3% harbored NSLNs+ and 15.6% harbored >3 positive nodes. Multivariate analysis showed that cN stage, the number of positive/negative SLN, pathological tumor stage, lympho-vascular invasion (LVI), multicenter, and molecular subtypes were significantly associated with NSLN metastasis. Similarly, multivariate analysis also showed that cN stage, the number of positive/negative SLNs, pathological tumor stage, and LVI could be independent predictors of >3 positive nodes. Then, nomograms for NSLN metastasis and >3 positive nodes were constructed using these parameters, respectively.ConclusionsThe nomograms will be useful in estimating positive NSLNs and >3 positive nodes, and they might provide advice for the optimization of RNI.

Abstract Breast cancer is the most prevalent cancerous tumor in women, characterized by different subtypes and varying responses to treatment. The continued evolution of breast cancer diagnosis and management has resulted in a transition from a one‐size‐fits‐all approach to a new era of personalized treatment plans. Therefore, it is essential to accurately identify the biological characteristics of breast tissue in order to minimize unnecessary biopsies of benign lesions and improve the overall clinical process, leading to reduced expenses and complications associated with invasive biopsy procedures. Challenges for future research include finding ways to predict the response of breast cancer patients to adjuvant systemic treatment. Dual‐energy CT (DECT) is a new imaging technology integrating functional imaging and molecular imaging. Over the past decade, DECT has gained relevancy, especially in oncological radiology. This article proposed a literature review of the application and research status of DECT in breast cancer treatment strategy determination and prognosis prediction.

Objective To explore diagnosis points of carotid artery ultrosound in patients of internal carotid artery (ICA) absence and other imaging features. Methods and Results Total 14 patients diagnosed with ICA absence in Tianjin Huanhu Hospital from January 2014 to May 2023 were retrospectively analyzed. Ten patients were male and 4 patients were female. The age of patients ranged from 13 to 79 years. Imaging exam: the CTA and (or) MRA of all patients showed absence of carotid canal, no development of the entire ICA, combined with intracranial vascular abnormalities. Eight of 14 patients had left ICA absence, 5 had right ICA absence, and one had bilateral ICA absence. According to collateral compensation LIE typing, 6 cases were type A, 2 cases were similar to type A with the existent of the A1 segment of ipsilateral anterior cerebral artery (ACA), 2 cases were type B, one case was type C, and one case was similar to type D as ipsilateral ACA was supplied by opposite through the anterior communicating artery, the ipsilateral middle cerebral artery (MCA) was supplied from the clinoid process of the contralateral ICA. Carotid artery ultrasound: all the 14 patients showed thin vessels in the extracranial segment of the common carotid artery (CCA) without bifurcation, which directly continued into external carotid artery (ECA), indicating the absence of one or both ICA absence; carotid artery bifurcation was not detected in multi⁃angle scanning of both 2D scan and color Doppler flow imaging, and the CCA directly continued into a single artery ECA with multiple branches; a "sawtooth" spectrum of the ipsilateral ECA was observed when tap the superficial temporal artery, which indicated that the artery was ECA; blood flow spectrum of the ipsilateral CCA was consistent with ipsilateral ECA. Conclusions Carotid artery ultrasound has high accuracy in the initial diagnosis of ICA absence. It is suitable for clinical application.

Keeping up with the development of the Internet era, it is imperative for colleges and universities to vigorously carry out the construction of a Chinese language and literature resource base to promote the healthy development of Chinese language and literature education. This paper starts with the construction of Chinese language literature resource base related technology, analyzes the basic model of the cognitive map and the construction of the cognitive map of Chinese language literature. The graph database technology is used to transform the data structure of the resource base and load data from the Chinese literature resource base. Based on the cognitive map and graph database, jointly constructed the Chinese language literature resource base and introduced the fuzzy C-mean integration algorithm to integrate the data resources for better access to Chinese language literature resources. To verify the effectiveness of the Chinese language and literature resource base constructed in this paper, it was tested and analyzed through practice. The results show that the overall average response time of the resource library in this paper is 718.50ms, which is 214.78ms lower than that of the online learning data platform, and the resource library developed in this paper can realize the loss in data sharing to be controlled to be less than 0.5MB. Utilizing the resource library to experiment with teaching Chinese language and literature, the average score of the experimental class increased from 88.96 to 95.23, which is an improvement of 6.27 points. The construction of the Chinese language and literature resource base under the cognitive mapping architecture can effectively enhance the common sharing of Chinese language and literature educational resources and prompt teachers to have richer teaching resources.

This paper constructs a Bayesian network text recognition model based on the Bayesian network and explores the role of Chinese language literature in the dissemination of traditional culture by analyzing the embodiment of traditional culture in Chinese language literature network texts. The collection process of Chinese language and literature data in network text is analyzed from the perspective of textual data interaction. The information of node variables in a Bayesian network is used to determine the mutual relationship between Chinese language literature and traditional culture. The degree of interdependence between Chinese literature and traditional culture can be measured by combining mutual information. The results show that the correct rate of text recognition of the Bayesian text recognition model decreases slightly when the training samples are (100-300), but the correct rate always stays around 0.85, thus reflecting the effectiveness of the network recognition model in this paper. Chinese language literature has a certain role in the dissemination of traditional culture, which proves that Chinese language literature, as a carrier of traditional culture, can improve the dissemination speed of traditional culture. This study focuses on the integration of Chinese literature and traditional communication to improve a new vision.

Abstract Background Accumulating evidence has confirmed the role of snoRNAs in a variety of cancer, but rare in renal cell carcinoma (RCC). This study aims to clarify the role of snoRNAs in RCC tumorigenesis and their potential as novel tumor biomarkers. Materials and methods The snoRNA expression matrix was obtained from the public TCGA and SNORic databases. SNORD15A, SNORD35B and SNORD60 were selected and validated by qPCR, then analyzed combined with related clinical factors using T-test and ROC curve. Results All three snoRNAs: SNORD15A, SNORD35B and SNORD60 were significantly upregulated in cancer tissues compared to adjacent tissues from TCGA or FFPE detection. These three snoRNAs were also increased in urinary sediment (US) of RCC as well as the early-stage RCC patients compared with the healthy controls. In addition, RNase stability experiments confirmed their stable existence in US. Meanwhile, the ROC curve shows that SNORD15A, SNORD35B and SNORD60 could effectively distinguish RCC (AUC = 0.7421) and early-stage RCC (AUC = 0.7465) from healthy individuals. Conclusion SNORD15A, SNORD35B and SNORD60 were upregulated in tissues and US of RCC, serving as novel potential biomarkers for RCC diagnosis.

Wheat， corn and rice， as the main body of grain production in China， are easily contaminated by trichothecenes （TCT）. Therefore， it is necessary to investigate the pollution status of TCT and assess the exposure risk of residents from these three kinds of grains and their related products. This study reviews the published studies about TCT pollution and exposure risk assessment of residents from wheat， corn， rice and their related products in China from 2011 to 2021. It is found that most of the grains and related products were polluted by TCT， and excessive TCT content was found in some studies. From a regional point of view， the pollution in the South was more serious than that in the North. The pollution of wheat and its related products was more serious than that of corn， rice and their related products. Exposure risk assessment of residents was mainly aimed at deoxynivalenol and its derivatives. The result showed that the average exposure level of residents in most areas was within the acceptable range， but some people were at risk. In the future， the prevention and control of all kinds of TCT in grains and related products should be strengthened， as well as the exposure risk assessment of residents.

ObjectiveTo evaluate the food exposure risk of ochratoxin A （OTA） in Zhejiang Province， China.MethodsA representative of 518 samples （five food categories including 24 kinds of food stuffs） were examined from 2018 to 2019 in order to evaluate the occurrence of OTA in Zhejiang Province. Food consumption data was collected from the Food Consumption Survey of Zhejiang Province between 2015 and 2016.ResultsOTA was only detected in grains and related products， but was not detected in fruits， tea， puffed foods and infant cereals. The higher incidence was found in oats and related products （16.1%，5/31）； the OTA levels of positive samples ranged from 0.53 to 4.00 μg/kg； and the maxium value of 4.00 μg/kg was found in oats and related products； no samples exceeded the limit set by China （5 μg/kg）. Exposure assessment showed that in most consumption scenarios， OTA probable daily intake for eating grains and related products were 0.004-7.360 ng/kg BW， less than OTA safety exposure value of 14 ng/kg BW； the highest OTA exposure value was 19.627 ng/kg BW and represents 140.19% of the safe intake. The 1-6 years old age group had the highest daily intake of 0.014-34.644 ng/kg BW， representing 0.10%-247.46% of the safe intake. The main food source of OTA was rice with a contribution rate of 87.22%-98.32% among different scenarios.ConclusionsThe OTA intakes through grains and related products consumption by Zhejiang population do not raise safety concerns except a few high intake groups， especially young consumers.

PurposeThe traditional shrinkage classification modes might not suitable for guiding breast conserving surgery (BCS) after neoadjuvant therapy (NAT). Aim was to explore the modified shrinkage classification modes to guide BCS after NAT.MethodsFrom April 2010 to 2018, 104 patients were included. All patients underwent MRI examinations before and after NAT. Residual tumors were removed and divided into more than 30 tissue blocks at 5-mm intervals. After performing routine procedures for paraffin-embedded histology, we made semiserial sections (6-μm thick). The MRI and pathology 3D models were reconstructed with 3D-DOCTOR software. Combined with traditional shrinkage modes and efficacy of NAT, we derived modified shrinkage classification modes which oriented by BCS purpose: modified concentric shrinkage modes (MCSM) and modified non concentric shrinkage modes (MNCSM). The MCSM means the longest diameter of residual tumor was less than 50% and ≤2cm in comparison with the primary tumor before NAT. Other shrinkage modes were classified as MNCSM.ResultsAccording to traditional shrinkage modes, 50 (48.1%) cases were suitable for BCS;while 70 (67.3%) cases were suitable for BCS according to the modified shrinkage modes (p=0.007). The consistency of MRI 3D reconstruction in assessing modified shrinkage classification modes was 93.2%, while it was 61.5% when assessing traditional shrinkage modes. Multivariate analysis showed that primary tumor stage, mammographic malignant calcification, molecular subtypes and nodal down-staging after NAT were independent predictors of modified shrinkage modes (all p

Abstract Background tRNA‐derived fragments (tRFs) have been found to play a regulatory role in the occurrence and development of many tumors. The aim of this study was to identify the expression of tRFs in breast cancer and their ability to serve as diagnostic markers for breast cancer. Methods Total RNA was extracted from breast cancer and paracancerous tissues (n = 83), as well as from the sera of breast cancer patients (n = 214) and healthy donors (n = 113) using trizol reagents. Expression of tRFs was then detected by q‐PCR, and analyzed using t‐test and ROC to illuminate their potential as biomarkers for breast cancer. Results Our results demonstrated that tRFs: tRF‐Gly‐CCC‐046, tRF‐Tyr‐GTA‐010 and tRF‐Pro‐TGG‐001 were downregulated in both tissues and sera from breast cancer patients as well as early‐stage patients compared with those in the healthy donors. More importantly, the three tRFs were capable of serving as circulating biomarkers of diagnostics and early diagnosis of breast cancer, possessing areas under the curve (AUC) of 0.7871 and 0.7987, respectively. Conclusions tRFs: tRF‐Gly‐CCC‐046, tRF‐Tyr‐GTA‐010 and tRF‐Pro‐TGG‐001 are downregulated in breast cancer and early breast cancer and act as new potential biomarkers for the diagnosis and early diagnosis of breast cancer.

To systematically review the knowledge attitudes and the influential factors on human papillomavirus (HPV) vaccination among Chinese women.

PurposeThe study aimed to explore whether the expression of lncRNAs in primary tumors could predict nodal efficacy after neoadjuvant therapy (NAT) for HER2+ breast cancer.MethodsTotal RNA was extracted from HER2+ breast cancer tissues before NAT (n=103) and from 48 pairs of cancers and para-cancers tissues that did not receive NAT. Different lncRNAs were selected by microarray, validated by qPCR, and analyzed to illuminate their potential as nodal efficacy biomarkers after NAT.ResultsOur results demonstrated that three lncRNA sets, lncRNA-AL390243.1, POTEH-AS1, and lncRNA-AC009975.1, were up-regulated in non-apCR tissues. The AUC value was 0.789 (95%CI: 0.703-0.876). The multivariate logistic regression analysis identified the expression of lncRNA-AL390243.1 (OR 5.143; 95% CI: 1.570-16.847), tumor type (OR 0.144; 95% CI: 0.024-0.855), and nodal stage (OR 0.507; 95% CI: 0.289-0.888) as independent predictors for apCR after NAT in HER2+ patients (all p

BackgroundThe genomic tests such as the MammaPrint and Oncotype DX test are being gradually applied for hormone receptor positive/HER-2 negative (HR+/HER2-) breast cancer patients with up to three positive axillary lymph nodes (ALNs). The first results from RxPONDER trial suggested that Oncotype DX could be applied to patients with 1-2 positive sentinel lymph nodes (SLNs) without axillary lymph node dissection (ALND), which constituted 37.4% of the intent-to-treat population. However, there was no distinctive research on how to apply genomic tests precisely to HR+/HER2- patients with 1-2 positive SLNs without ALND. The purpose was to construct a nomogram using the multi-center retrospective data to predict precisely which HR+/HER2- candidates with 1-2 positive SLNs could be subjected to genomic tests (≤ 3 positive lymph nodes).MethodsWe conducted a retrospective analysis of 18,600 patients with stage I-III breast cancer patients treated with sentinel lymph node biopsy (SLNB) in Shandong Cancer Hospital, Fudan University Shanghai Cancer Center, and West China Hospital. The univariate and multivariate logistic regression analysis was conducted to identify the independent predictive factors of having ≤ 3 positive nodes among patients with 1-2 positive SLNs. A nomogram was developed based on variables in the final model with p

MiRNAs regulate gene expression by forming base pairing with mRNAs to inhibit the translation of those mRNAs. In many mammalian genomes each, about 2000 miRNAs were found to regulate roughly 60% of all the genes in that genome. Many experimental validations and computational predictions have been done on miRNA:mRNA interactions. Nonetheless, the interactions from different sources are not always consistent. In this study, we integrated multiple online resources, including mirTarBase, TarBase, miRanda, miRDB, PITA, and TargetScan, and developed eleven large-scale datasets containing miRNA:mRNA interactions that are consistent among a specific subgroup of above-mentioned online resources. In addition, a new integrated confidence score was designed to show the significance for all the miRNA:mRNA interactions.

In blended learning, how to explore and evaluate the learner’s interest is very important. In this paper, we study on modeling of learners’ interest from the perspective of cognitive neuroscience. Emotional cognitive theory and brain cognitive process for situational learning interest were introduced. In addition, in order to solve the problem of quantitative assessment of interest, learner’s online operation behaviour was summarized through data mining methods, and the learners' interest regression model was built. Experimental results show that the accuracy of the model is more than 91% and it has good applicability in blended learning.