乳腺良恶性病变的磁共振T2*W首过灌注成像与血管生成相关性研究

Objective： To study the diagnostic value of T2^＊-weighted first-pass perfusion imaging in breast tumors. Methods： We analyzed the magnetic resonance imaging （MRI） information along with the pathological and immunohistochemistry results. Magnetic resonance imaging was performed in 28 patients with breast tumor. The time to signal intensity curves were generated according to the T2^＊-weighted first-pass perfusion imaging. The curve＇s maximal signal intensity drop rate and maximal signal intensity decrease time were analyzed and compared with the pathological diagnoses after surgery. Results： Malignant breast lesions showed higher maximal signal intensity drop rate （44.69% ± 17.07 vs. 17.22% ±7.49, P 〈 0.001） than benign lesions, but there was no significant difference of maximal signal decrease time between those two lesions （23.94 s ± 4.92 vs. 20.02 s ± 6.83, P 〉 0.05）. Conclusion： The T2^＊-weighted first-pass perfusion imaging has enough sensitivity and specificity in breast tumor diagnosis.     

原位杂交法检测BP1基因在乳腺癌组织中表达

目的探讨BP1同源盒基因在乳腺癌中的表达及其与临床病理指标的关系。方法收集165例乳腺癌临床和病理资料,采用原位杂交法检测BP1的表达,同时用二步法进行ER、p53、PCNA、bcl2、cerbB2免疫组化染色。结果BP1基因表达率为67.88%,免疫组化:ER70.30%、p5349.09%、PCNA74.55%、bcl253.33%、cerbB275.52%。BP1与bcl2具有相关性(P<0.01),且均与ER相关(P<0.05),与p53呈负相关(P<0.05)。BP1与PCNA、cerbB2、患者年龄、组织学类型、淋巴结转移等无相关性。结论BP1可能通过某种非依赖p53基因调控机制,与bcl2、ER协同抑制肿瘤细胞的凋亡而参与乳腺癌的发生。     

Thrombotic occlusion of the common carotid artery (CCA) in acute ischemic stroke treated with intravenous tissue plasminogen activator (TPA)

Although common carotid artery (CCA) occlusions are rare, acute clinical presentations vary from mild to devastating strokes primarily due to tandem occlusions in the intracranial arteries. Three patients with acute CCA occlusions were treated with systemic tissue plasminogen activator (TPA). Blood pressures were kept at the upper limits allowed with TPA therapy with fluid balance and the 'head-down' position. Recanalization occurred in intracranial vessels only. Marked early neurological improvement occurred in two of three patients. CCA occlusions should not be considered contra-indication to systemic thrombolysis.     

Increased plasma cathepsin D concentration in hepatic carcinoma and cirrhosis but not in breast cancer

Using a sandwich enzyme-linked immunoassay, plasma total cathepsin D concentration was assayed in 40 breast cancer patients and 84 patients with various liver diseases and compared to that of 52 normal subjects. There were no significant variations found in breast cancer patients related to tumor size, node invasiveness or metastases. In normal women, cathepsin D levels were slightly but not significantly increased in the luteal phase and in pregnancy. By contrast, plasma cathepsin D concentration was significantly increased in 70-75% of patients with liver disease (cirrhosis, hepatocarcinoma, hepatitis), but not in those with liver steatosis. Cathepsin D was independent of most of the plasma hepatic function tests and was correlated with alpha-fetoprotein in cirrhosis and with alpha-fucosidase in primary hepatocellular carcinoma. We conclude that plasma cathepsin D is not a useful marker in breast cancer. However, since the cellular level of this protease is associated with risk of metastasis in breast cancer, clinical follow-up will be required to test whether high cathepsin D plasma concentration has any prognostic value in liver cirrhosis and primary hepatocarcinoma.     

Investigation of the Effect of Neoadjuvant Chemotherapy on Stage Ⅱ Breast Cancer

OBJECTIVE To investigate the effect of neoadjuvant chemotherapy in treatment of Stage Ⅱ breast cancer. METHODS The data from 113 patients with breast cancer of the same pathologic type in Stage Ⅱ,during the period of 1995 to 2001,were analyzed retrospectively.Among the patients,47 were treated with neoadjuvant chemotherapy,and 66 received no adjuvant therapy before surgery（control group）.After the patients of the neoadjuvant chemotherapy group had received 2 courses of chemotherapy with the CMF regimen,the surgical procedure was conducted. RESULTS Complete remission（CR）was attained in 9 of the 47 cases receiving neoadjuvant chemotherapy and partial remission（PR）was reached for 22 cases.The rate of breast-conserving surgery was enhanced from 22.73%to 46.81%（P〈0.05）in the neoadjuvant treatment group. There was no difference in the 5-year overall survival（OS）and disease-free survival（DFS）rate between the two groups（P〉0.05）,but the 5-year OS and DFS of the cases with clinical tumor remission was higher compared to the control group（P〈0.05）. CONCLUSION Neoadjuvant chemotherapy can enhance the rate of breast conservation for Stage Ⅱ breast cancer and may improve the prognosis of the cases with clinical remission.     

乳腺癌骨髓微转移的检测及其临床意义

目的　检测乳腺癌骨髓微转移 ,探讨其与乳腺癌临床病理学因素的关系。方法　采用RT -PCR法 (一步法 )检测骨髓中CK19mRNA表达。结果　 10 2例乳腺癌患者骨髓CK19mR NA表达阳性率 5 6.9%。骨髓CK19mRNA表达率随乳腺癌肿块增大而增高 ;随临床分期增加而增高 ;随组织学分级增加而增高。但与腋淋巴结转移与否无关 ,亦与乳腺癌患者年龄、月经状况及病理类型无关。结论　乳腺癌骨髓微转移与某些临床病理学因素有关。癌细胞播散无固定模式 ,早期乳腺癌亦可发生远处转移。骨髓微转移应作为常规检测方法 ,以更早、更准确地预测全身转移情况 ,进行个体化治疗。     

冠心病危险因素与冠状动脉病变程度的相关性研究

目的:探讨冠心病危险因素与冠状动脉病变程度的关系.方法:选取150例冠心病患者行冠状动脉造影术及各项化验检查,冠状动脉病变程度以Gensini积分值表示,对冠心病危险因素和冠状动脉病变程度进行统计分析.结果:经多因素线性回归证实:非高密度脂蛋白胆固醇为冠状动脉病变程度的独立危险因素(P=0.030),而性别、年龄、空腹血糖、糖尿病、高血压、吸烟、家族史及甘油三酯、低密度脂蛋白胆固醇均与冠状动脉病变程度无明确相关.结论:非高密度脂蛋白胆固醇对冠状动脉病变严重程度具有重要的影响.     

健康信念模式在分娩中的应用探讨

目的探讨增强产妇健康信念对产妇分娩方式及产后康复的影响，提高产妇康复质量及产科工作质量。方法将300例产妇随机分为观察组和对照组，对观察组产妇进行分娩相关知识强化培训，增强产妇自然分娩及自我护理信念．对照组只进行一般入院宣教，比较两组剖宫产率、纯母乳喂养、产后24小时自护率等指标。结果观察组产妇剖宫产率明显低于对照组，而纯母乳喂齐、产后24小时自护率等指标均高于对照组。结论增强产妇健康信念，能帮助其自然分娩，降低剖宫产率，提高产妇康复质量。     

穿刺加三苯氧胺治疗乳腺囊肿的疗效观察(附36例)

目的：比较乳腺可扪及囊肿穿刺抽液后服用三苯氧胺和单纯穿刺抽液两种治疗方法的疗效.方法：将临床可扪及乳腺囊肿根据乳腺B超检查结果入组68例,随机分为穿刺抽液治疗组32例和穿刺抽液后服三苯氧胺治疗组36例,两组患者穿刺抽液后中位随访13个月观察疗效.结果：68例可扪及乳腺单纯囊肿,平均囊肿大小23mm,36例穿刺服三苯氧胺组复发率13.89%（5/36）,32例穿刺抽液组复发率37.50%（12/32）,两组相比较（P＜0.05）有显著性差异.乳腺囊肿病史＞1年的患者,穿刺服三苯氧胺组和穿刺组复发率分别是36.36%（4/11）和77.78%（7/9）,两组相比较（P＜0.05）差异有显著性.对单个囊肿,多发囊肿,囊肿病史＜1年患者,两种治疗方法不影响复发率（P＞0.05）.结论：临床可扪及乳腺单纯囊肿可根据B超检查筛选适合穿刺患者,穿刺抽液加服三苯氧胺治疗可减少复发,囊肿病史＞1年者复发率较高.     

Prolonged exclusive breastfeeding is associated with increased atopic dermatitis: a prospective follow-up study of unselected healthy newborns from birth to age 20 years

BACKGROUND: Exclusive breastfeeding for the first 6 months is recommended by the World Health Organization and considered allergy preventive. However, it is not known whether prolonging exclusive breastfeeding for over 6 months provides further benefit in allergy prevention. OBJECTIVE: The aim of this prospective 20-year follow-up study was to find out whether the allergy protective effect can be enhanced by prolonging strictly exclusive breastfeeding for > or =9 months of age. A total of 200 unselected healthy newborns were enrolled in the study. Their mothers were encouraged to maintain exclusive breastfeeding for as long as possible. The number of infants on strictly exclusive breastfeeding was 167 at 2, 116 at 6, 36 at 9 and 7 at 12 months of age. Of the 200 infants, 42% had a family history of allergy. The children were re-assessed at ages 5 (n=163), 11 (n=150) and 20 years (n=164) with clinical examination, skin prick testing, and parental and personal structured interviews. RESULTS: Exclusive breastfeeding prolonged for > or =9 months was associated with atopic dermatitis (P=0.002) and symptoms of food hypersensitivity (P=0.02) at age 5 years, and with symptoms of food hypersensitivity at age 11 years (P=0.01), in children with a family history of allergy. CONCLUSION: Prolonging strictly exclusive breastfeeding for > or =9 months was not helpful in atopy prevention, instead, it was associated with increased atopic dermatitis and food hypersensitivity symptoms in childhood.