Practical uses of contrast‐enhanced spectral mammography in daily work: A pictorial review

Contrast‐enhanced spectral mammography (CESM) has a number of uses including the work‐up of inconclusive findings on mammography, assessment of breast symptoms, cancer staging, evaluation of response to neoadjuvant chemotherapy and recently as an alternative to magnetic resonance imaging (MRI) in high‐risk screening. CESM can be swiftly incorporated into the workflow of busy breast clinics. We share our experiences with CESM at a large breast assessment centre in Western Australia.     

化毒清湿汤对复杂性肛瘘新型探查术后患者手术创面恢复功效研究

目的:研究化毒清湿汤对于复杂性高位肛瘘新型探查术后患者手术创面恢复及相关细胞因子水平的改善功效。方法: 从接受复杂性肛瘘新型探查术治疗的患者中选取104例纳入本次研究,入选患者随机均分为对照组与治疗组,对照组给予术后常规治疗,治疗组在对照组疗法的同时加用化毒清湿汤治疗,于术后2 d、15 d分别对比两组患者的创面面积、疼痛程度,观察创面愈合时间; 术后28 d评估两组疗效,同时观察两组患者术后2 d、28 d时血清细胞生长因子与炎性因子水平的变化。结果:治疗组总有效率98.08%高于对照组的86.54%(P<0.05); 术后15 d两组创面面积、疼痛VAS评分均有所降低且两组比较治疗组更低; 治疗组创面愈合时间为(23.71±5.57)d,对照组为(30.46±7.92)d,两组比较治疗组更低(P<0.05); 术后28 d两组各项细胞生长因子均有上升,组间比较治疗组更高,差异具有统计学意义(P<0.05); 术后28 d两组各项炎性因子均有好转,组间比较治疗组更优,差异具有统计学意义(P<0.05)。结论:化毒清湿汤可提高复杂性肛瘘新型探查术临床疗效,加快患者术后后创口愈合速度,进一步改善患者细胞生长因子与炎性因子的表达水平。     

肿瘤坏死因子α增强全反式维甲酸诱导早幼粒白血病细胞凋亡

目的:分析肿瘤坏死因子α增强全反式维甲酸诱导早幼粒白血病细胞凋亡的作用。方法:选择NB4人急性早幼粒白血病细胞，利用全反式维甲酸单独作用，并选择肿瘤坏死因子α联合全反式维甲酸作用，测定细胞增殖以及细胞凋亡情况。结果:随着早幼粒白血病细胞分化的逐渐进行，单一组、联合组的细胞增殖速度均慢慢下降；随着早幼粒白血病细胞分化的逐渐加深，单一组、联合组细胞凋亡率慢慢升高；分化2天，联合组细胞CD11b阳性率明显高于单一组，P<0.05。结论:全反式维甲酸具有诱导早幼粒白血病细胞分化、凋亡的作用，而肿瘤坏死因子α会增强全反式维甲酸的作用效果。     

Low-dose naltrexone inhibits the epithelial-mesenchymal transition of cervical cancer cells in vitro and effects indirectly on tumor-associated macrophages in vivo

The metastasis of cervical cancer has always been a clinical challenge. We investigated the effects of low-dose naltrexone (LDN) on the epithelial mesenchymal transition of cervical cancer cells in vitro as well as its influence on macrophage polarization and associated cytokines in vivo. The results suggested that LDN supressed the proliferation, migration and invasion abilities and promote their apoptosis in Hela cells, whereas the opioid growth factor receptor (OGFr) silenced significantly reversed these effects in vitro. Knockdown the expression of OGFr, the inhibitory of LDN on EMT was weakened. LDN could inhibit cervical cancer progression in nude mice. In additon, LDN indirectly reduced the number of tumor-associated macrophages (TAMs), mainly M2 macrophages, and decreased expression of anti-inflammatory factor IL-10 in the serum of nude mice. These findings demonstrate that LDN could be a potential treatment for cervical cancer.     

LacdiNAc-Glycosylated Prostate-specific Antigen Density is a Potential Biomarker of Prostate Cancer

BackgroundSerum LacdiNAc-glycosylated prostate-specific antigen (LDN-PSA) and LDN-PSA density together with PSA and PSA density (PSAD) were measured as a diagnostic tool for prostate cancer (PCa).Patients and MethodsWe included 150 patients with PCa without hormonal therapy and 41 patients without PCa obtained from the Kyoto University Hospital between 2012 and 2017. LDN-PSA levels were measured through a WFA–anti-PSA antibody sandwich immunoassay using a highly sensitive surface plasmon field-enhanced fluorescence spectroscopy (SPFS) system. Diagnostic performance of serum LDN-PSA and LDN-PSAD was evaluated by measuring the area under the receiver-operating characteristic curve (AUC).ResultsThe AUCs of LDN-PSA, LDN-PSAD, and PSAD levels (0.780, 0.848, and 0.835, respectively) detected in patients with PCa were significantly higher (P = .0001, P < .0001, and P < .0001, respectively) than that of PSA (0.590). Moreover, among 143 patients with PCa who received radical prostatectomy (RP), the AUCs of LDN-PSA, LDN-PSAD, and PSAD levels (0.750, 0.812, and 0.769, respectively) detected in patients with a pathologic Gleason grade group ≥ 2 were significantly higher (P = .0170, P = .0028, and P = .0003, respectively) than that of PSA (0.578). In the group comprising 35 patients who received RP with a Gleason grade group 1-graded biopsy, the LDN-PSA, LDN-PSAD, and PSAD levels were significantly different (P = .0097, P = .0024, and P = .0312, respectively). However, PSA alone could not discriminate cases with adverse features (P = .454).ConclusionsLDN-PSAD is a potential marker for detecting PCa and selecting candidates for RP.     

Role of optical coherence tomography angiography in the characterization of vascular network patterns of ocular surface squamous neoplasia

PurposeTo visualize and quantify vascular networks in individuals with ocular surface squamous neoplasia (OSSN) through optical coherence tomography angiography (OCTA).MethodCross-sectional study of OSSN patients. Vascular networks were measured by OCTA in the epithelium and sub-epithelial space in the tumors, adjacent tissue, and in the contralateral eye. Vessel area density (VAD, percent of blood vessels within 2.14 mm²), was calculated for each location. Total tumor density (TTD, percent of blood vessels within the entire tumor) was calculated. VAD was assessed separately for corneal and conjunctival locations and compared.ResultsFifteen patients with OSSN were included. The mean age was 61 ± 12 years and the majority were male (80%). The mean tumor area, volume, depth, and TTD were 28.0 ± 9.0 mm² (range, 10.9–39.7), 9.1 ± 4.1 mm³ (range, 3.4–18.8), 334 ± 125 μm (range, 177–571), and 33.2% ± 11.0% (range, 18.7–58.8), respectively. The VAD was highest within the tumor (28.9% ± 8.7%) followed by the adjacent sub-epithelial tissue and the tissue underneath the conjunctival component of tumor. These densities were higher than the VAD in the tissues of the non-involved eye (all P < 0.05). The VAD within conjunctival component of tumor was significantly higher than those with corneal component (29.8% ± 9.5% vs. 21.1% ± 5.5%, p = 0.006). The VAD under conjunctival tumor was also significantly higher than under corneal component (24.1% ± 7.8% vs. 17.0% ± 6.1%, p = 0.024).ConclusionsOCTA imaging allowed for visualization and quantification of vessel structure and density within, under, and surrounding OSSN.     

Intermittent theta-burst stimulation moderates interaction between increment of N-Acetyl-Aspartate in anterior cingulate and improvement of unipolar depression

BackgroundIntermittent theta-burst stimulation (iTBS), a novel repetitive transcranial magnetic stimulation (rTMS) technique, appears to have antidepressant effects when applied over left dorsolateral prefrontal cortex (DLPFC). However, its underlying neurobiological mechanisms are unclear. Proton magnetic resonance spectroscopy (¹H-MRS) provides in vivo measurements of cerebral metabolites altered in major depressive disorder (MDD) like N-acetyl-aspartate (NAA) and choline-containing compounds (Cho). We used MRS to analyse effects of iTBS on the associations between the shifts in the NAA and Cho levels during therapy and MDD improvement.MethodsIn-patients with unipolar MDD (N = 57), in addition to treatment as usual, were randomized to receive 20 iTBS or sham stimulations applied over left DLPFC over four weeks. Single-voxel ¹H-MRS of the anterior cingulate cortex (ACC) was performed at baseline and follow-up. Increments of concentrations, as well as MDD improvement, were defined as endpoints. We tested a moderated mediation model of effects using the PROCESS macro (an observed variable ordinary least squares and logistic regression path analysis modeling tool) for SPSS.ResultsImprovement of depressive symptoms was significantly associated with decrease of Cho/NAA ratio, mediated by NAA. iTBS had a significant moderating effect enhancing the relationship between NAA change and depression improvement.ConclusionsOur findings suggest a potential neurochemical pathway and mechanisms of antidepressant action of iTBS, which may moderate the improvement of metabolic markers of neuronal viability. iTBS might increase neuroplasticity, thus facilitating normalization of neuronal circuit function.