Chao Tian

Sleep disorders and anxiety-depression symptoms can significantly impair the quality of life and treatment adherence among breast cancer patients undergoing chemotherapy, while also increasing the risk of disease recurrence and mortality. Early identification of the progression trajectory and underlying causes of these symptoms is essential for providing personalized interventions for deteriorating cases. This study aims to analyze the trajectories of sleep disorders and anxiety-depression symptoms in breast cancer patients during chemotherapy using a group-based Multi-Trajectory Model (GBMTM) and to identify influencing factors through machine learning. Prospective data from 150 breast cancer patients undergoing four cycles of chemotherapy were collected. A GBMTM was employed to identify distinct trajectories, with 70 predictive variables included in the analysis. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to select the optimal subset of variables. Seven machine learning models were compared, and the optimal model was chosen for result interpretation using SHAP (SHapley Additive exPlanations) analysis. Among breast cancer patients undergoing chemotherapy, two distinct trajectories of sleep disorders and anxiety-depression symptoms were identified: the "stable group" (74.7%) and the "deteriorating group" (25.3%). SHAP analysis revealed that high levels of C-reactive protein, high uric acid, high hemoglobin, smoking, presence of invasive cancer with ductal carcinoma in situ, prior chemotherapy, being married, regular menstrual cycles in the past, and lack of family history were significant risk factors associated with the "deteriorating group." Our findings indicate two distinct trajectories of sleep disorders and anxiety-depression symptoms in breast cancer patients undergoing chemotherapy, with the majority falling into the "stable group". The identified risk factors associated with the "deteriorating group" should be closely monitored to facilitate early intervention and improve patient outcomes. The trial was registered on Chinese Clinical Trial Registry (Trial ID: ChiCTR2300077667 on 15 November 2023; available at https://www.chictr.org.cn/).

Background: Common adverse reactions to breast cancer chemotherapy (nausea, vomiting, sleep disorders, anxiety, depression) are often suboptimally managed. These symptoms undermine patients’s quality of life and reduce chemotherapy adherence. Two non-invasive Traditional Chinese Medicine (TCM) interventions—transcutaneous electrical acupoint stimulation (TEAS) and acupressure have demonstrated efficacy in alleviating such discomforts, data on their effectiveness and dynamic therapeutic characteristics throughout the full chemotherapy course remain insufficient. Method: 198 breast cancer patients receiving chemotherapy were subjected to simple randomization using R4.4.2, and randomly assigned to the control group, TEAS group, and acupressure group for a longitudinal follow-up over four chemotherapy cycles. Generalized estimating equations (GEE) were used to analyze intervention effects and post-hoc multiple comparisons, supplemented by intention-to-treat (ITT) analysis and per-protocol set (PPS) analysis. Results: Main time effect: With the progression of chemotherapy cycles, the risk of delayed chemotherapy-induced nausea and vomiting (delayed CINV) significantly increased; patients’ anxiety levels were higher in the early stage of chemotherapy cycles and showed a downward trend after the 3rd cycle. Main intervention effect: TEAS significantly improved patients’ quality of life(QOL), while acupressure primarily alleviated psychological symptoms such as anxiety and depression. Interaction effect: The therapeutic effect of TEAS was cumulative, exerting more pronounced benefits in reducing the risk of delayed CINV, improving sleep quality, and relieving delayed nausea during the mid-to-late stages of chemotherapy (cycles 3-4); acupressure achieved optimal anxiety relief in the early stage (cycle 1) and progressively alleviated delayed nausea and enhanced QOL throughout the treatment course. Conclusion: TEAS and acupressure exhibit dynamic and distinct effects in mitigating adverse reactions in breast cancer patients undergoing chemotherapy. TEAS is more suitable for the comprehensive improvement of physical symptoms and QOL during the mid-to-late stages of chemotherapy, while acupressure is preferred for early anxiety relief and gradual improvement of psychosomatic symptoms throughout the treatment. These findings provide a reference for the development of individualized non-invasive clinical intervention strategies. Clinical trial registration: https://www.chictr.org.cn/ , identifier ChiCTR2300077667.

Objective: To evaluate the effectiveness of transcutaneous electrical acupoint stimulation (TEAS) in relieving postoperative pain and reducing the incidence of postoperative nausea and vomiting (PONV) in patients undergoing cancer surgery. Methods: A systematic search was conducted in PubMed, Web of Science, Embase, the Cochrane Library, CNKI, and Wanfang databases to identify randomized controlled trials (RCTs) published between January 2015 and May 2025. Postoperative pain scores at different time points, assessed using the visual analog scale (VAS) or numerical rating scale (NRS), as well as the incidence of PONV, postoperative nausea (PON), and postoperative vomiting (POV), were extracted. Subgroup analyses were performed according to the timing of TEAS intervention and pain assessment methods. The risk of bias was evaluated using the Cochrane Risk of Bias (RoB) tool, and the meta-analysis was conducted using RevMan 5.4 software. Results: A total of 16 randomized controlled trials involving 2,017 postoperative cancer patients were included (1,125 in the TEAS group and 892 in the control group). Meta-analysis of 13 studies showed that TEAS significantly reduced postoperative pain scores (SMD = −1.19, 95% CI: −1.42 to −0.95, p < 0.00001). Eleven studies indicated that TEAS decreased the incidence of PONV (RR = 0.47.95% CI:0.37~0.61, P p < 0.00001). Another four studies showed a downward trend in postoperative vomiting but without statistical significance (RR = 0.69, 95% CI: 0.44 to 1.09, p = 0.11). Conclusion: TEAS appears to be an effective adjunctive intervention for alleviating postoperative pain and nausea in patients undergoing cancer surgery, showing clear clinical advantages. Further high-quality, large-scale, and multicenter studies are warranted to confirm its long-term efficacy and to promote the standardization of TEAS protocols for broader clinical application. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251038890

Accurate and efficient motion estimation is a crucial component of real-time ultrasound elastography (USE). However, obtaining radiofrequency ultrasound (R

Purpose: MORC4 has recently been characterized as a breast cancer-associated anti-apoptotic oncoprotein. In the current study, we explored its downstream regulation in luminal A/B breast tumors. Materials and Methods: Bioinformatic prediction was performed using data from The Cancer Genome Atlas (TCGA)-breast cancer (BRCA). Cellular and molecular studies were conducted using luminal A/B representative MCF-7 and BT-474 cell lines. Results: ENST00000355610.8 (encoding MORC4a isoform) was the dominant transcript in breast cancer. ChIP-qPCR and dual-luciferase assay confirmed two STAT3-binding sites in the MID2 promoter in both MCF-7 and BT-474 cells. Co-IP confirmed an interaction between MORC4 and STAT3. ChIP-qPCR data indicated that MORC4 inhibition led to remarkably decreased enrichment of the STAT3-binding MID2 promoter segments. MORC4 overexpression significantly elevated BCL-2 expression in MCF-7 cells and increased their resistance to adriamycin (ADM), 5-fluorouracil (5-FU), and cisplatin (DDP). MID2 inhibition largely abrogated MORC4-induced drug-resistance. However, the drug-resistant phenotype was rescued by overexpressing MID2-MT that was resistant to MID2 siRNA. Conclusion: This study revealed a novel regulatory mechanism of MORC4 on MID2 expression via STAT3-mediated transcriptional activation. This regulatory axis might confer increased chemoresistance to breast cancer cells.