Background: This prospective study compared the diagnostic value of tumor stiffness and serum soluble E-cadherin (sE-cadherin) expression for predicting response to neoadjuvant therapy in HER2-positive breast cancers. Methods: 112 patients with early or locally advanced HER2-positive breast cancer were enrolled. Maximum stiffness (Emax), mean stiffness (Emean) and their relative changes were assessed at t0 and t2. sE-cadherin levels were analyzed using ELISA. Pathological complete response was defined as no invasive disease in the breast and axilla (ypT0/is, ypN0) after surgery. The ability of tumor stiffness, sE-cadherin and the combination of ΔEmean (the relative change in Emean after the second cycle of neoadjuvant therapy) and sE-cadherin in predicting tumor responses was assessed using receiver operating characteristic curves and the Z-test. Results: Tumor stiffness and sE-cadherin decreased during neoadjuvant therapy. ΔEmean and sE-cadherin revealed the best predictive performance, with areas under the curve (AUCs) of 0.843 and 0.857, respectively. No significant differences in AUCs were reported between ΔEmean and sE-cadherin (p = 0.795). The combined use of ΔEmean and sE-cadherin showed the highest sensitivity and specificity (93.22 and 90.57%, respectively), with an AUC of 0.937. Conclusion: The combination of ΔEmean and sE-cadherin may improve the predictive power of each single factor. Although further verification is required, this study may promote noninvasive prediction of neoadjuvant therapy responses and help personalize the treatment regimen.

Background: This study systematically evaluated and analyzed the efficacy of quantitative exercise intervention on colonoscopy intestinal preparation.Methods: A systematic search was performed using the Cochrane Library, the JBI evidence-based database, Embase, Web of Science, CINAHL, Medline, CNKI, the China Biomedical Literature Database (CBM), and the Wanfang database to identify literature relating to the efficacy of exercise intervention on bowel preparation for colonoscopy. Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) published from the establishment of the database to July 2021 were included. After screening the literatures, relevant data was extracted and evaluated for quality. The RevMan 5.3 software was used for meta-analysis.Results: A total of 8 studies with 1,486 patients, including 747 in the intervention group and 739 in the control group, were included in this meta-analysis. The results of 4 studies showed that the use of quantitative exercise intervention programs did significantly improve the quality of the patient's bowel preparations [mean difference (MD) =2.15, 95% confidence interval (CI): 0.04 to 4.26; P=0.046]. The results of 6 studies demonstrated that the use of quantitative exercise intervention programs can effectively improve the patient's bowel preparation adequacy rate [relative risk (RR) =1.25, 95% CI: 1.05 to 1.49; P=0.012].Meta-analysis of 5 studies showed that the use of quantitative exercise intervention programs can reduce the incidence of nausea in patients (RR =0.52; 95% CI: 0.37 to 0.74; P=0.000). Analysis of 4 studies revealed that quantitative exercise intervention can reduce the incidence of vomiting in patients (RR =0.36; 95% CI: 0.23 to 0.56; P=0.000). Furthermore, evaluation of 4 studies demonstrated that quantitative exercise intervention reduced the incidence of abdominal pain in patients (RR =0.50; 95% CI: 0.28 to 0.89; P=0.019), and reduced the incidence of abdominal distension (RR =0.60; 95% CI: 0.36 to 0.99; P=0.047).Discussion: Quantitative exercise intervention can effectively improve the quality of intestinal preparation before colonoscopy and reduce the incidence of adverse reactions.

BACKGROUNDFocal nodular hyperplasia (FNH) has very low potential risk, and a tendency to spontaneously resolve. Hepatocellular adenoma (HCA) has a certain malignant tendency, and its prognosis is significantly different from FNH. Accurate identification of HCA and FNH is critical for clinical treatment.AIMTo analyze the value of multi-parameter ultrasound index based on logistic regression for the differential diagnosis of HCA and FNH.METHODSThirty-one patients with HCA were included in the HCA group. Fifty patients with FNH were included in the FNH group. The clinical data were collected and recorded in the two groups. Conventional ultrasound, shear wave elastography, and contrast-enhanced ultrasound were performed, and the lesion location, lesion echo, Young’s modulus (YM) value, YM ratio, and changes of time intense curve (TIC) were recorded. Multivariate logistic regression analysis was used to screen the indicators that can be used for the differential diagnosis of HCA and FNH. A ROC curve was established for the potential indicators to analyze the accuracy of the differential diagnosis of HCA and FNH. The value of the combined indicators for distinguishing HCA and FNH were explored.RESULTSMultivariate logistic regression analysis showed that lesion echo (P = 0.000), YM value (P = 0.000) and TIC decreasing slope (P = 0.000) were the potential indicators identifying HCA and FNH. In the ROC curve analysis, the accuracy of the YM value distinguishing HCA and FNH was the highest (AUC = 0.891), which was significantly higher than the AUC of the lesion echo and the TIC decreasing slope (P < 0.05). The accuracy of the combined diagnosis was the highest (AUC = 0.938), which was significantly higher than the AUC of the indicators diagnosing HCA individually (P < 0.05). This sensitivity was 91.23%, and the specificity was 83.33%.CONCLUSIONThe combination of lesion echo, YM value and TIC decreasing slope can accurately differentiate between HCA and FNH.

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