前哨淋巴结活检对乳腺癌外科导航的临床分析

目的 探讨前哨淋巴结活检(SLNB)对乳腺癌手术导航的临床价值及可靠性。方法 用染料法(1％亚甲蓝)对30例乳腺癌病人进行腋窝前哨淋巴结(SLN)染色切除。术中冰冻切片，术后石蜡切片，并常规行腋窝淋巴结清除术(ALND)。结果 SLN染色成功率96．7％(29／30)，失败1例。SLN阳性10例，后站淋巴结有癌转移6例(60％)，无癌转移4例（40％)。SLN阴性19例，其中假阴性1例，后站淋巴结均无癌转移。SLNB评价：检出率96．7％、准确率93．3％、敏感度90．9％、假阴性率9．1％、假阳性率0。结论 只要提高技术水平，SLN染料着色和检出率都相对较高，对外科术式选择有实际指导意义。相信SLNB取代传统的ALND已为时不远。     

Bioengineered muscle constructs and tissue-based therapy for cardiac disease

Bioengineering of contractile muscle tissues and organs for disease treatment is currently in the preclinical experimental stage of development. Cell biology over the last several decades has primarily focused on breaking down tissues and cells to smaller and smaller components to understand their functioning at the molecular level. We are just beginning to understand how to reassemble these components back into larger functional units. The merging of the fields of traditional engineering, biomaterials, cell biology, and computer science will lead to the ex vivo engineering tissues and organs for many cardiovascular applications in the future. For pediatric cardiology, bioengineered contractile tissues may serve as force generating cardiac patches, heart valve papillary muscle substitutes, or as living therapeutic protein delivery ‘devices’ when bioengineered from genetically engineered muscle cells.     

原发性肺黏液腺癌的CT征像及病理基础(附32例报告)

目的:探讨原发性肺黏液腺癌(primary pulmonary mucinous adenocarcinoma,PPMA)的CT征象及病理基础.方法:回顾性分析经手术、气管镜或CT引导下穿刺活检病理证实的32例PPMA患者的临床、病理及影像资料,观察病变的形态、位置、病灶内及周边情况、增强表现及有无转移等征象.结果:3...     

超声造影与MRI对乳腺癌患者腋窝淋巴结诊断价值

目的比较超声造影和MRI对乳腺癌患者腋窝淋巴结诊断价值。方法回顾分析常规超声诊断为乳腺癌患者的腋窝淋巴结超声造影与MRI影像学资料,以临床病理结果为"金标准",比较两种方法诊断腋窝淋巴结转移的价值。结果病理结果显示97枚腋窝淋巴结中,淋巴结转移69枚,淋巴结无转移28枚;超声造影诊断乳腺癌患者腋窝淋巴结转移的灵敏度、特异度、准确率分别为79.71%、96.43%、84.54%;MRI诊断乳腺癌患者腋窝淋巴结转移的灵敏度、特异度、准确率分别为88.41%、92.86%、89.69%;超声造影结果显示腋窝淋巴结转移组的SImax-SImin显著高于无转移组(P<0.05),MRI结果显示腋窝淋巴结转移组的淋巴结短径、长径及皮质厚度均高于无转移组(P<0.05)。结论两种方法均可有效诊断乳腺癌患者腋窝淋巴结转移,可以依据检查方法的特点为患者选择合适的诊断方法。     

On the road to precision,there is more practical medicine to be implemented

Estimates are that of the annual global burden of 1.5 million new cases of breast cancer, two-thirds have hormone receptor positive tumors; a majority of these women come from low- and middle-income countries. For adjuvant patients with hormone receptor positive tumors, a major goal is identification of a “precision medicine”, implying a genomic, test whose application will allow identification of those whose systemic treatment can be hormonal therapy alone. Such tests in current use are very expensive and thus in the foreseeable future are out of reach of most women who pay out of pocket.For some time it has been evident that quantitative scoring of tumors for intensity and prevalence of tumor-cell staining for estrogen or progesterone receptor (ER or PR) expression (the commonest system was first described by Allred and thus provides “Allred” scores) gives an inexpensive measure of likelihood of response to hormonal therapies – a different predictive, precision medicine tool. Majorities of hormone receptor positive tumors (one third of all patients) have “Allred” scores of 6–8 (versus scores of 3–5) for both ER and PR and these tumor-bearing patients benefit significantly more from hormonal treatments than their lowering scoring-afflicted women. When ER and PR quantitative intensity and prevalence scoring is combined with Her-2/neu testing and careful tumor histologic grading, luminal A and B type tumors can be well-defined and gene-expression testing adds little practical predictive information.For women with hormone receptor positive tumors, high quality, cost-effective “precision medicine” is available without tumor gene-expression testing.     

免疫检查点抑制剂相关心肌炎的诊治进展

免疫调节是控制恶性肿瘤进展的重要决定因素,免疫检查点抑制剂(ICIs)的应用为恶性肿瘤治疗带来突破性进展,很大程度上改善了患者的生存时间和生活质量,然而不可避免的是,其也带来免疫相关不良反应(irAE)毒性风险.本文就ICIs相关心肌炎的发病机制、发病率、诊断和治疗策略进行综述.     

Hepatitis B virus X protein boosts hepatocellular carcinoma progression by downregulating microRNA-137

BackgroundHepatocellular carcinoma (HCC) is a frequent diagnosed malignancy. microRNAs (miRs) are involved in various cellular processes during cancer development. This study attempted to probe the miR-based mechanism in hepatitis B virus X protein (HBx) small interfering RNA (siRNA)-treated HCC cells.MethodsHBx expression in hepatocyte and HCC cells was detected, and cells with highest HBx expression were screened out and transfected with HBx-siRNAs. Then the effect of HBx on HCC cell proliferation was detected. miRs differentially expressed in HBx-siRNA-transfected MHCC97H cells were analyzed and verified. miR-137 methylation was analyzed by bioinformatics, and miR-137 restoration was detected after Aza treatment. Furthermore, miR-137 methylation in MHCC97H cells with HBx knockdown or HBx overexpression was detected by methylation specific PCR. The targeting relationship between miR-137 and Notch1 was verified. Then the gain-and-loss functions of miR-137 or/and Notch1 were performed to estimate their roles in HCC cell proliferation. The effects of HBx-siRNA and overexpressed miR-137 in vivo were observed by tumor xenograft in nude mice and immunohistochemistry.ResultsHBx-siRNA weakened MHCC97H cell proliferation and tumor growth. miR-137 was highly expressed in HBx-siRNA-treated HCC cells and targeted Notch1. HBx knockdown decreased miR-137 methylation and restored miR-137 expression. miR-137 overexpression prevented HCC cell proliferation and tumor growth, while miR-137 downregulation reversed the repressing effects of HBx-siRNA on HCC cell proliferation. Inhibition of Notch1 reversed HCC cell proliferation induced by miR-137 downregulation.ConclusionOverexpression of miR-137 blocks HCC cell proliferation in HBx-siRNA-treated MHCC97H cells by targeting Notch1. This study may offer novel target for HCC treatment.     

shRNA靶向沉默CNTN1表达抑制乳腺癌细胞株MDA-MB-468增殖及克隆形成能力

目的:探讨短发夹RNA(shRNA)靶向沉默CNTN1基因表达对乳腺癌MDA-MB-468细胞增殖及克隆形成能力的影响。方法:采用RT-PCR和Western blot法检测乳腺癌细胞株MCF7-ADR、MDA-MB-468、MCF7以及Hs578T中的CNTN1 mRNA和蛋白表达水平。采用LipofectamineTM2000 向MDA-MB-468细胞株转染成功构建的靶向沉默CNTN1表达的shRNA载体片段,并采用RT-PCR法和Western blot法进行鉴定。分别通过MTT法、流式细胞仪技术和平板克隆实验检测各组细胞增殖及克隆形成能力的改变。结果:CNTN1 mRNA和蛋白表达水平在MDA-MB-468中最高。沉默组MDA-MB-468细胞发生G1期阻滞,增殖能力明显降低(P＜0.05),克隆形成能力明显减弱(P＜0.05)。结论:CNTN1基因在乳腺癌MDA-MB-468细胞中高表达,沉默其表达可抑制乳腺癌MDA-MB-468细胞增殖和克隆形成能力。     

肝癌模型大鼠内侧前额叶皮层GABA能中间神经元电活动变化

目的：研究肝癌模型大鼠内侧前额叶皮层（mPFC）GABA能中间神经元放电频率和放电形式的变化。方法：应用在体细胞外电生理学记录的方法观察肝癌模型大鼠mPFC GABA能中间神经元自发电活动的变化。结果：肝癌模型大鼠GABA能中间神经元的放电频率明显增加（P〈0.01）,使其从（5.56±0.66）Hz增至（9.24±0.53）Hz,放电形式趋向爆发（P〈0.01）。结论：肝癌对大鼠mPFC GABA能中间神经元的电活动影响明显。