[A comparative study of breast cancer mass screening and opportunistic screening in Chinese women]

Objective: To compare the population characteristics, the positive rate of screening, the detection rate of breast cancer, early diagnosis rate and the cost between the mass screening group and opportunistic screening group of breast cancer. Methods: This study is a prospective multicenter cohort study conducted from January 1, 2014 to December 31, 2016. The participants were enrolled for mass screening or opportunistic screening of breast cancer. After completing the questionnaire, all the participants received breast physical examination and breast ultrasound examination every year for 3 rounds by year. The participants' characteristics and screening results of the two groups were compared by χ² test, Fisher exact test or Wilcoxon rank-sum test. Results: A total of 20 080 subjects were enrolled. In the mass screening group, 9 434 (100%), 8 111 (85.98%) and 3 940 (41.76%) cases completed the 3 rounds of screening, and 10 646 (100%), 6 209 (58.32%) and 2 988 (28.07%) cases in the opportunistic screening group, respectively. In the opportunistic screening group, the proportions of less than 3 months lactation (1 275/9 796 vs. 1 061/8 860, χ²=4.597, P=0.032), non-fertility (850/10 646 vs. 574/9 434, χ²=27.400, P<0.01), abortion history (6 384/10 646 vs. 5 062/9 434, χ²=81.232, P<0.01), postmenopausal (2 776/10 646 vs. 2 217/9 434, χ²=17.757, P<0.01), long-term oral contraceptives(>6 months) (171/10 646 vs. 77/9 434, χ²=25.593, P<0.01) and family history of breast cancer in first-degree relatives (464/10 646 vs. 236/9 434, χ²=51.257, P<0.01) were significantly higher than those in mass screening group. The positive rate of screening (514/10 646 vs. 128/9 434, χ²=194.736, P<0.01), the detection rate of breast cancer (158/10 646 vs. 13/9 434, χ²=107.374, P<0.01), and positive rate of biopsy (158/452 vs. 13/87, χ²=13.491, P<0.01) in the opportunistic screening group were significantly higher than those of the mass screening group. The early diagnosis rate of the mass screening group was significantly higher than the opportunistic screening group (10/12 vs. 66/141, χ²=5.902, P=0.015). The average cost for detecting each breast cancer case of the mass screening group was 215 038 CNY, which was 13.6 times of the opportunistic screening group (15 799 CNY/case). In the opportunistic screening group, the positive rate of biopsy in primary hospitals was significantly lower than that in large-volume hospitals (79/267 vs. 79/185, χ²=8.267, P=0.004), but there was no significant difference in the mass screening group (6/37 vs. 7/50, χ²=0.082, P=0.774). Conclusions: Breast cancer screening can improve early detection rate. Compared with the mass screening mode, the opportunistic screening mode has the advantages of higher proportion of high-risk factors, higher positive rate of screening, higher detection rate of breast cancer, higher positive rate of biopsy, and lower cost of screening. However, the early diagnosis rate of breast cancer of opportunistic screening is lower than that of mass screening. The positive rate of opportunistic screening in primary hospitals is lower than that of large-volume hospitals. The two screening modes have their own advantages and should be chosen according to local conditions of different regions in China.

Influence of angiogenesis inhibitors, endostatin and PF-4, on lymphangiogenesis

This study was designed to screen potential safe and effective inhibitors of lymphangiogenesis. Lymphatic endothelial cells from pig thoracic duct were isolated and cultured. The control group, 3 endostatin, and 3 PF-4 experimental groups were tested for effects on proliferation and distance of migration of the cultured cells by two methods (method of the scraping line and MTT assay), and observations by light, confocal, and electron microscopy were also made. Total cells migrating past the scrape line for the endostatin control group was 28.6 +/- 1.2 (mean +/- standard error) and the 3 endostatin experimental groups (50 ng/ml, 100 ng/ml, and 150 ng/ml), respectively, were 17.5 +/- 0.6, 10.5 +/- 0.5, and 4.8 +/- 0.3 (all p < 0.05 cf control). Migration distance for the endostatin control group was 381.7 +/- 9.67 microm, and the migration distance of the 3 endostatin experimental groups, respectively, were 252.9 +/- 5.58, 164.5 +/- 7.09, and 91.2 +/- 7.98 microm (all p < 0.05). Cell migration number for the PF-4 control group was 28.3 +/- 1.0 compared with doses of 40 ng/ml, 80 ng/ml, or 120 ng/ml of PF-4, respectively, were 13.6 +/- 0.7, 9.5 +/- 0.6, and 4.6 +/- 0.4 (all p < 0.05 cf control). Migration distance of cells in PF-4 control group was 419.9 +/- 5.87 microm, and the 3 PF-4 experimental groups, respectively, were 199.2 +/- 8.16, 152.5 +/- 7.28, and 104.2 +/- 6.70 microm (all p < 0.05 cf control). The MTT assay confirmed that as the concentrations of endostatin and PF-4 were increased, the inhibitory effect was increased. We conclude that endostatin and PF-4 are able to inhibit the migration and proliferation of lymphatic endothelial cells, and these effects are dose-dependent.

[Microdialysis sampling and microbore liquid chromatography with electrochemical detection for determination of serotonin in rat brain striatum]

AIM

To develop a sensitive method for determination of serotonin in biological samples.

METHODS

A combination of microdialysis sampling and microbore liquid chromatography with electrochemical detection (LCEC) was established.

RESULTS

Changes of serotonin in fg or pg in microdialysates from brain striatum of the free moving rat were easily determined.

CONCLUSION

This developed method was useful for living animal research. Serotonin level in corpus striatum healthy rats was quite stable.

Separation and characterization of the metabolic products of lappaconitine in rat urine by high-performance liquid chromatography

The separation and characterization of the metabolic products of lappaconitine in rat urine by high-performance liquid chromatography with electrochemical and ultraviolet detection are described. Urine samples from rats intravenously administered lappaconitine hydrobromide were extracted with chloroform and then purified on a Sep-Pak C18 cartridge. The subsequent resolution into individual compounds was achieved by high-performance liquid chromatography. Identification of these compounds was based on comparisons of the chromatographic behaviour and the detector response with those of authentic samples. Changes in the ratio of lappaconitine to its metabolites in rat urine with time after dosing led to a proposal for one of the probable metabolic pathways of lappaconitine in the rat.

Studies on the metabolism of lappaconitine in humans. Identification of the metabolites of lappaconitine in human urine by high performance liquid chromatography

The metabolites of lappaconitine in the urine of humans having been previously administered intramuscularly with lappaconitine hydrobromide were studied using high performance liquid chromatography with electrochemical and ultraviolet detection. The urine was extracted by means of liquid- and solid-phase extractions. Each of the metabolites of lappaconitine was purified by high performance liquid chromatography on a reversed phase column and identified on the basis of the chromatographic behaviour and the detector response. It was proved that lappaconitine, N-deacetyl-16-O-demethyllappaconitine and N-deacetyllappaconitine were excreted in urine from humans receiving lappaconitine.

Studies on steroids. CCXXIX. Separation and characterization of catechol oestrogen glucuronides in urine of pregnant women by high-performance liquid chromatography

The separation and characterization of catechol oestrogen glucuronides in the urine of pregnant women by high-performance liquid chromatography with electrochemical detection is described. The urine samples from pregnant women were passed through Amberlite XAD-2 and Sep-Pak C18 columns and subsequented to ion-exchange chromatography on piperidinohydroxypropyl Sephadex LH-20 to isolate the oestrogen glucuronide fraction. The subsequent resolution into individual oestrogen glucuronides was achieved by high-performance liquid chromatography on a reversed-phase column. 2-Hydroxyoestrone 2-glucuronide and 4-hydroxyoestrone 4-glucuronide were identified on the basis of their behaviour in high-performance liquid chromatography with three different mobile phases. Derivatization of two glucuronides with 2-ferrocenylethylamine, followed by chromatographic separation and measurement of hydrodynamic voltammograms with an electrochemical detector was carried out for unequivocal identification. Enzymatic cleavage of the glucuronoside linkage followed by the identification of deconjugated catechol oestrogens by high-performance liquid chromatography with electrochemical detection further supported the structural assignment of these metabolites. The ratio between the amounts of 2-hydroxyoestrone 2-glucuronide and 4-hydroxyoestrone 4-glucuronide excreted in the urine of pregnant women was found to be ca. 5:1.

Studies on steroids. CCXIX. Separation and determination of 4-hydroxyoestriol monoglucuronides and monosulphates in biological fluids by high-performance liquid chromatography with electrochemical detection

The separation and determination of 4-hydroxyoestriol monoglucuronides and monosulphates by high-performance liquid chromatography with electrochemical detection on a reversed-phase column has been carried out. The effects of the salt, composition and pH of the mobile phase on the resolution were investigated with a Develosil ODS-5 column. Each group of isomeric monoglucuronides and monosulphates of 4-hydroxyoestriol was efficiently resolved on this column when 0.5% sodium acetate-acetonitrile and 0.5% sodium acetate-tetrahydrofuran-acetonitrile were used as mobile phases, respectively. The use of the present method revealed that 4-hydroxyoestriol orally administered to the rat was excreted as 4-, 3-, 16-glucuronides and 4-sulphate in bile.