Oncol2012: 原发性乳腺淋巴瘤一例报道及超声研究

To the editor:Primary lymphoma of the breast is extremely rare.Here we report a case of a diffuse large B-cell lymphoma in a 20-year-old female patient.Some of the sonographic features were similar to those of a carcinoma,and this lesion may have been easily misdiagnosed as breast cancer. A 20-year-old female presented with a one-month history of a rapid growth mass in her right breast.On clinical examination,a right-breast oval mass was palpated in the upper-outer quadrant,no tenderness,no adhesions with the skin,no orange peel-like changes,and no nipple retraction or elevation.In the right axillary region,enlarged lymph nodes were found,and there were no other enlarged superficial lymph nodes.Blood examination was normal,and urinalysis was negative.Chest X-ray and abdominal ultrasonography were also normal.Breast ultrasonography revealed a hypoechoic mass (size:3.8 cm × 1.8 cm × 1.4 cm) in the upper-outer quadrant with ill-defined boundaries and an irregular shape.The inner echo of the mass was heterogeneous and the posterior echo was substantially enhanced (Figure 1).     

特拉唑嗪在治疗老年顽固性高血压中的疗效观察

目的探讨特拉唑嗪在治疗老年原发性顽固性高血压的临床疗效。方法将我院收治的80例顽固性高血压患者随机分成两组,均为原发性高血压。对照组36例使用拜新同及安博诺治疗,治疗组44例在对照组的基础上加用特拉唑嗪治疗,两组疗程均为6周。结果治疗组的总有效率明显高于对照组,两组相比较差异有统计学意义（P〈0.05）;两组治疗后的收缩压与舒张压均较治疗前有明显下降,治疗前后差异具有统计学意义（P〈0.05）,治疗组的降压效果明显优于对照组。结论盐酸特拉唑嗪联合多种降压药治疗老年顽固性高血压效果良好,副作用少,值得临床推广。     

子宫颈部富于细胞性平滑肌瘤MR表现1例

病例女,55岁。因查体发现宫颈肿块1天来我院就诊。妇科查体：外阴及阴道未见明显异常,宫颈光滑,萎缩不良。宫颈质硬增粗,未见明显肿块。经阴超声发现：子宫颈部前壁可见2．6cm×1．7cm不均质回声区,边界欠清,内未见血流.     

青少年特发性脊柱侧凸病人围术期护理

青少年特发性脊柱侧凸病人发病年龄多在12岁~17岁,其发病率为2%~3%[1],男女比例为1∶4[2]。由于病人独特的年龄及性别特点,疾病带来的明显体型外观改变往往给病人造成一定程度的心理障碍,而且此种心理障碍可能造成病人的自卑、自闭、远离社会甚至可能造成部分病人自杀倾向。而此种心理障碍可能是驱使绝大部分病人初诊及选择手术治疗的主要原     

Gastrointestinal symptoms are predictive of trajectories of cognitive functioning in de novo Parkinson's disease

IntroductionNon-motor symptoms such as cognitive and gastrointestinal (GI) symptoms are common in Parkinson's disease (PD). In PD, GI-symptoms often present prior to motor symptoms. It is hypothesized that GI-symptoms reflect disruptions of the microbiome-gut-brain axis, which leads to altered immune functioning, chronic neuroinflammation, and subsequent neurodegeneration. Initial evidence links gut-dysbiosis to PD pathology and motor symptom severity. The present study examines the longitudinal relationship between severity of GI-symptoms and cognitive impairment in newly diagnosed PD patients.MethodsA secondary data analysis of the Parkinson's Progression Markers Initiative (PPMI) included 423 newly diagnosed PD patients who were followed for up to 5 years. Participants underwent neuropsychological tests of processing speed, attention, visuospatial functioning, verbal learning and verbal delayed recall. Participant were classified as cognitive intact, mild cognitive impairment or Parkinson's disease dementia. Frequency of GI-symptoms were assessed with the Scales for Outcomes in Parkinson's Disease Autonomic (SCOPA-AUT). Multi-level models (MLM) examined the longitudinal relationship between GI symptoms and cognitive impairment.ResultsAll cognitive outcomes were predicted by the main effect of GI symptoms, or the GI-symptom X Occasion interaction term. Specifically, more severe GI-symptoms were predictive of a less favorable trajectory of performance on tests of letter fluency, visuospatial, learning and memory. Cognitive performance was uniquely associated with GI-symptoms and unrelated to non-GI autonomic symptoms.ConclusionsThe presence of GI symptoms may serve as an early marker of cognitive impairment in PD. Future studies should examine specific mechanisms underlying the relationship between gut-dysbiosis and cognitive impairment.     

Using unique molecular identifiers to improve allele calling in low-template mixtures

PCR artifacts are an ever-present challenge in sequencing applications. These artifacts can seriously limit the analysis and interpretation of low-template samples and mixtures, especially with respect to a minor contributor. In medicine, molecular barcoding techniques have been employed to decrease the impact of PCR error and to allow the examination of low-abundance somatic variation. In principle, it should be possible to apply the same techniques to the forensic analysis of mixtures. To that end, several short tandem repeat loci were selected for targeted sequencing, and a bioinformatic pipeline for analyzing the sequence data was developed. The pipeline notes the relevant unique molecular identifiers (UMIs) attached to each read and, using machine learning, filters the noise products out of the set of potential alleles. To evaluate this pipeline, DNA from pairs of individuals were mixed at different ratios (1−1, 1−9) and sequenced with different starting amounts of DNA (10, 1 and 0.1 ng). Naïvely using the information in the molecular barcodes led to increased performance, with the machine learning resulting in an additional benefit. In concrete terms, using the UMI data results in less noise for a given amount of drop out. For instance, if thresholds are selected that filter out a quarter of the true alleles, using read counts accepts 2381 noise alleles and using raw UMI counts accepts 1726 noise alleles, while the machine learning approach only accepts 307.     

犬移植肺缺血再灌注实验动物模型的建立

目的为深入研究缺血再灌注对移植肺功能损害的发生机制,克服以往体外肺灌注模型存在的局限性,我们建立了模拟的犬肺自体原位移植模型。方法选用杂种犬１５只,建立左肺原位缺血模型,３小时后（热缺血１小时,冷缺血２小时）,开放左肺动、静脉,结扎对侧肺动脉,监测缺血３小时再灌注６小时过程中动脉血氧分压（ＰａＯ２）、动脉血二氧化碳分压（ＰａＣＯ２）、动脉血氧饱和度（ＳａＯ２）、平均肺动脉压（ＭＰＡＰ）的变化。结果再灌注前后的ＰａＯ２,ＭＰＡＰ有差异（Ｐ＜０．０５）。结论该动物模型能够较好地反映缺血再灌注对犬移植肺功能的损害,并具有一定的可复制性和扩展性     

Vacuolating cytotoxin purified fromHelicobacter pyloricauses mitochondrial damage in human gastric cells

We investigated the effects of vacuolating cytotoxin (VacA) prepared fromHelicobacter pylorion the metabolism of gastric epithelial cells, AZ-521. VacA caused the ATP levels to decrease in a time-dependent manner; by approximately 20% in 6 h, 35% in 12 h and 50% in 24 h, at a concentration of 120 nM. This decrease was also dependent on the concentration of VacA. To evaluate the impairment of mitochondria by VacA, mitochondrial membrane potential was estimated by flow cytometric analysis using 3, 3′-dihexyloxacarbocyanine iodide as a substrate. VacA decreased membrane potential with the relative fluorescence intensity of AZ-521 cells in 6 h from 52±3 to 24±1. Treatment of the cells with bafilomycin A1, a specific inhibitor of vacuolar ATPase proton pump, showed no apparent effect on these changes in the levels of ATP and the mitochondrial membrane potential. Secondly, we estimated the effect of VacA on oxygen consumption. VacA inhibited oxygen consumption in AZ-521 cells: the levels of PO₂in the medium of control cells decreased by 73% in 3 h and 37% in 6 h, whereas those in VacA-treated cells were 84% in 3 h and 59% in 6 h. Flow cytometric analysis showed the number of cells in the G₀/G₁phase was increased by VacA. Taken together, VacA induced an inactivation of energy metabolism followed by mitochondrial damage, leading to impairment of the cell cycle in gastric epithelial cells.     

The cost of Alzheimer's disease in China and re-estimation of costs worldwide

Introduction

The socioeconomic costs of Alzheimer's disease (AD) in China and its impact on global economic burden remain uncertain.

应用富血小板血浆混合透明质酸钠治疗膝骨关节炎

目的比较富血小板血浆＋透明质酸钠(PRP＋HA)混合物与单纯使用PRP关节腔内注射治疗Ⅱ期和Ⅲ期膝骨关节炎患者的疗效。 方法选择2014年2月至2014年5月,山东大学附属省立医院和威海市立医院门诊收治的126例Ⅱ、Ⅲ期(Keligren Lawrence分级)膝关节骨关节炎的患者,随机分为PRP＋HA混合物组(63例,63膝)和PRP组(63例,63膝),两组患者性别、年龄、身体质量指数、Keligren Lawrence分级、疼痛视觉模拟评分(VAS)、美国西部安大略与麦克马斯特大学骨关节炎指数(WOMAC)评分分别采用t检验和χ²检验比较。患者接受每周1次的HA＋PRP混合物(2 ml HA＋3.5 ml PRP)关节腔内注射或只注射PRP(3.5 ml)治疗持续3周。在第1、3、6和12个月记录VAS评分和WOMAC评分,采用t检验比较治疗后不同时间点的疗效。 结果两组患者性别、年龄、BMI的差异均无统计学意义(P >0.05),具有可比性。在使用PRP＋HA混合物和单纯PRP治疗的患者中,相比治疗前患者的状态,VAS评分明显降低,膝关节的功能(WOMAC)明显改善。就VAS和WOMAC而言,两组之间差异没有统计学意义(VAS：t＝0.862,P>0.05;WOMAC：t＝1.765,P>0.05);然而,PRP＋HA混合物组有1种能获得更好的功能评分的趋势。两组中没有发现重大不良反应或并发症。 结论PRP＋HA混合物治疗Ⅱ、Ⅲ期膝骨关节炎的患者是安全有效的。