Initial experience of magnetic seed localization for impalpable breast lesion excision: First 100 cases performed in a single Irish tertiary referral centre

IntroductionWire guided localization has been widely utilized as the standard method of pre-operative localization of breast lesions. Magnetic seeds were developed to counter some of the disadvantages associated with wires. This aim of this study was to assess outcomes following the introduction of magnetic seeds at a tertiary specialist breast centre.MethodsA retrospective review of a prospective database of the first 100 patients who underwent magnetic seed (Magseed) guided breast surgery between November 2018 and November 2019. Data was collected from 17 wire guided cases completed during the trial phase for comparison. The primary outcome measures were successful excision of index lesion and retrieval of the magnetic seed. Secondary outcomes analyzed included time ready for theatre, post-operative complications and breast margin re-excision rate.ResultsOf these 100 cases, 85 patients underwent Magseed guided wide local excision for invasive or in-situ carcinoma and 15 underwent Magseed guided diagnostic excision. The primary lesion was excised, and Magseed was retrieved in all 100 cases. 54% of patients were ready to proceed as the first scheduled theatre case of the day, compared to 0% of wire-guided cases. Amongst therapeutic Magseed guided cases, the re-excision rate for margin clearance was 9.4%.ConclusionMagseed guided breast excision is a new technology that has been implemented with relative ease in our unit. We have shown that magnetic seed guided surgery reliably localizes lesions, is associated with low re-excision rates without an increase in patient morbidity or mortality and results in improvements in theatre planning and efficiency.     

三种术式治疗肝细胞癌的近期临床疗效比较

目的比较腹腔镜切除术(LR)、开腹切除术(OR)与超声定位下的射频消融术(RFA)治疗肝细胞癌的近期临床疗效。 方法回顾性分析2010年6月至2018年6月接受手术治疗的152例肝细胞癌患者的病例资料,71例患者纳入LR组,52例患者纳入OR组,29例患者纳入RFA组。采用SPSS 25.0软件分析数据,手术相关指标、VAS评分等计量资料以( ±s)描述,行f检验;近期疗效、并发症等计数资料行χ²检验,P<0.05为差异有统计学意义。 结果三组患者术后3个月治疗总有效率比较,LR组(76.1%)>OR组(73.1%)>RFA组(72.4%),差异无统计学意义(P>0.05)。三组手术时间、术中总出血量及住院时间相比,OR组>LR组>RFA组(P<0.05);术后24 h及1周后VAS评分比较,OR组>LR组>RFA组(P<0.05);OR组并发症总发生率(36.5%)>LR组(29.6%)>RFA组(6.7%),差异有统计学意义(P<0.05);术后随访3个月的复发率比较,OR组(7.7%)0.05)。 结论对分期早且肿瘤小的肝细胞癌患者分别采用LR术、OR术与RFA术治疗,患者近期疗效相当,但RFA术具有损伤小、术后恢复快等优点,可减轻患者术后疼痛程度,安全性更高。但对于瘤体较大且靠近重要血管胆管的肝细胞癌患者,还需进行个体化治疗。     

达芬奇机器人周围肺磨玻璃结节术前定位指征的研究

目的探讨肺磨玻璃结节的术前定位指征。方法纳入北部战区总医院自2012年4月至2019年9月收治的192例应用达芬奇机器人手术系统切除肺部磨玻璃结节患者,男95例、女97例,平均年龄(56.47±11.79)岁。所有患者完善术前检查,按术前是否予以定位,分为定位组(n=97)和不定位组(n=95);定位组按磨玻璃实质不同分为纯磨玻璃结节(pGGO)组(n=23),混合磨玻璃结节(mGGO)组(n=74);未定位组分为pGGO组(n=14),mGGO组(n=81)。各个组又根据结节大小及与胸膜距离与能否探查及结节,得出相应的线性函数。结果术前行亚甲蓝定位组的手术时间短于不定位组手术时间。在散点图中描绘结节相对应直径和深度及能否探及到的坐标点,并对所有坐标点进行线性回归得出的线性函数[深度=0.648×直径–1.446(单位为mm)]可作为达芬奇机器人手术pGGO节术前定位的指征;线性函数[深度=0.5595×直径ᒰ0.56(单位为mm)]可作为达芬奇机器人手术mGGO术前定位的指征。结论结果提示该方程可作为临床周围肺磨玻璃结节的术前定位指征。     

术中胸腔内胸壁定位法在肺结节术中的应用体会

背景与目的：探讨一种简单、安全、准确、无创的肺结节术中定位方法,以供更多的术者参考,惠及更多的肺结节患者。方法：收集100例在浙江省舟山医院胸心外科行亚肺叶切除术的肺小结节患者。结合术前CT影像,测定肺结节在胸壁内侧壁层胸膜上的定位点后,电凝钩留置在此点上,嘱麻醉师充分鼓肺后屏气,电凝钩在肺表面留下烧灼点,为肺小结节在胸膜表面的定位点。切下标本后,测量肺表面定位烧灼点与结节之间距离、结节与切缘距离数据,来评价定位准确性。结果：定位准确率达99.1%,其中仅有1例患者肺小结节与定位点有明显偏差（>1.5 cm）,二次切割后找到肺结节,其余患者均为一次性切除成功,手术成功率为100.0%,无并发症发生。结论：术中胸腔内胸壁定位法无创、简便、安全,无并发症发生,尤其对特殊部位肺结节能较准确定位,有明显的优势,值得推广。     

Physico-chemical characterization and pharmacological evaluation of sulfated polysaccharides from three species of Mediterranean brown algae of the genus Cystoseira

Background

Seaweed polysaccharides are highly active natural substances having valuable applications. The present study was conducted to characterize the physico-chemical properties of sulphated polysaccharides from three Mediterranean brown seaweeds (Cystoseira sedoides, Cystoseira compressa and Cystoseira crinita) and to evaluate their anti-radical, anti-inflammatory and gastroprotective activities.

Methods

The different rates of neutral sugars, uronic acids, L-fucose and sulphate content were determined by colorimetric techniques. The different macromolecular characteristics of isolated fucoidans were identified by size exclusion chromatography equipped with a triple detection: multiangle light scattering, viscometer and differential refractive index detectors, (SEC/MALS/VD/DRI). Anti-inflammatory activity was evaluated, using the carrageenan-induced rat paw edema test in comparison to the references drugs Acetylsalicylate of Lysine and Diclofenac. The gastroprotective activity was determined using HCl/EtOH induced gastric ulcers in rats and to examine the antioxidant effect of fucoidans in the three species, the free radical scavenging activity was determined using 1,1-diphenyl-2-picrylhydrazyl.

Results

The pharmacological evaluation of the isolated fucoidans for their anti-inflammatory, and their gastroprotective effect established that these products from C. sedoides, C. compressa and C. crinita exhibited a significant anti-inflammatory activity at a dose of 50 mg/kg, i.p; the percentages of inhibition of the oedema were 51%, 57% and 58% respectively. And, at the same dose, these fucoidans from C. sedoides and C. compressa showed a significant decrease of the intensity of gastric mucosal damages compared to a control group by 68%, whereas, the fucoidan from C. crinita produced a less gastroprotective effect. Furthermore, the isolated fucoidans exhibited a radical scavenging activity.

Conclusion

The comparative study of fucoidans isolated from three species of the genus Cystoseira showed that they have similar chemicals properties and relatives anti-radical, anti-inflammatory and gastroprotective activities which are found to be promising.     

应用fMRI技术探查静息态经前期综合征肝气郁证患者中枢脑区定位

目的：探寻与经前期综合征肝气郁证发病密切相关的脑区。方法：采用BOLD-功能磁共振成像技术,影像学数据基于matlab平台的SPM 8软件以及rest软件进行图片处理,每个簇块体积阈值（Cluster）大于389个连续体素,单体素阈值P<0.05（校正后）的脑区定义为差异有统计学意义的区域,病例组和对照组采用双样本t检验。结果：PMS肝气郁证患者与正常对照相比,额叶、枕叶、岛叶、边缘叶、基底核、扣带回等脑区激活增强。结论：PMS肝气郁证患者发病与额叶、枕叶、岛叶、边缘叶、基底核、扣带回等脑区有关。     

肝细胞癌转铁蛋白受体表达的免疫电镜研究

用转铁蛋白受体（ＴＦＲ）单抗ＯＫＴ５，以免疫电镜技术，对肝细胞癌（ＨＣＣ）ＴＦＲ的表达作亚细胞定位研究，结果表明，ＴＦＲ电镜下呈电子密度较高的颗粒状物质，肝癌细胞大量表达，正常肝细胞不表达或少量表达，肝癌细胞的ＴＦＲ分布在细胞，但更多地分布的胞浆，从而证实先前定位与定量的研究结果，并根据ＴＦＲ所在位置，就其在细胞的动态过程作了探讨。     

LCE3C在皮肤癌组织中分布和细胞定位及其调控机制的初步研究

目的 研究LCE3C蛋白在皮肤鳞状细胞癌( SCC)以及基底细胞癌( BCC)中的分布及其调控的分子机制. 方法免疫组织化学法检测LCE3C在SCC和BCC组织中的表达. 构建绿色荧光蛋白融合表达的 LCE3C 重组表达载体pLCE3C-GFP,转染人SCC细胞系A431,采用激光共聚焦显微镜分析LCE3C在A431细胞中的定位. Western blot法检测转录因子GRHL3对LCE3C表达的影响.结果 免疫组化结果显示,与正常皮肤组织比较,LCE3C在SCC和BCC组织中表达明显增加;在皮肤癌组织中LCE3C主要分布在表皮的角质层. 激光共聚焦结果显示,LCE3C主要分布在细胞外基质( ECM )中;Western blot 结果显示,与角质形成细胞( HaCaT)比较, A431 细胞中 GRHL3 表达量显著降低,而LCE3C表达量明显增高;过量表达 GRHL3 的细胞( A431/GRHL3)LCE3C表达量显著降低.结论 与正常皮肤组织比较, LCE3C在皮肤癌中的表达增加,主要分布在皮肤角质层的ECM;转录因子GRHL3与皮肤癌组织LCE3C的表达呈负相关性.