吃主食护大肠

英国剑桥大学最近在一项研究中,分析了10多个国家的人的饮食习惯和癌症之间的关系,结果发现,食用淀粉类食物越多,小肠、结肠和直肠癌的发病率越低.比如,以肉类食物为主食的澳大利亚人,结肠癌发病率是以淀粉类食物为主食的中国人的4倍.     

凉菜拌出夏日风情

不知不觉又进入了夏季,南方的潮湿,北方的燥热,常常使人食欲不振,精神委靡,尤其是对于康复期的病友来说,怎一个"热"字了得.夏季的饮食调养,应选择清凉爽口、少油腻、易消化的食物.这时从配角一跃成为主角的凉菜就闪亮登场了,不论生拌、热炝,每道菜都做足了开胃功夫,它们少油,少盐,对我们的健康大有裨益;省时省力,让我们减轻在厨房的劳动强度.只要掌握烹饪技巧,制作起来还是很简单的.     

过敏体质,怎么吃?

什么是过敏呢?过敏反应又称作变态反应,是患者身体对一种或多种物质的过强反应.其主要机制是由于过敏性素质患者的体内产生了过多的过敏抗体——免疫球蛋白E,它和环境中的过敏原相互作用,刺激机体产生和释放某些过敏介质,导致不同组织的损伤,继而产生各种症状.     

文艺汇演群星璀璨

2006年1月8日,中国抗癌协会癌症康复会在"北京展览馆剧场"圆满成功地举办了"阿斯利康首届全国癌症康复者文艺汇演--生命恋歌".这次文艺汇演有26个省、市上报节目50多个,经筹备组认真筛选,选出正式参加演出的节目16个,特邀节目3个,出演的癌症患者近300人.     

钻石之光--山药

"每个人都能在自家的后院找到钻石",有人借用此言,把山药比做养生的钻石. 山药是一种薯科植物,它的根茎垂直而颀长,往往盈尺,生长在坚硬的山冈的土质中,旋转攀缘.阳光下,山药的叶子很美,颜色从浓到浅,绿得缤纷,但被我们称之为钻石的是它营养丰富的块状根茎.山药的外观看上去粗糙,细小密布的根须如刺如须,但削了皮,却洁白得如水生荸荠,分泌一些透明的黏液,柔滑得抓它不住,仿佛泥鳅从手中挣脱.     

Benefit of adjuvant chemoradiotherapy in patients with pathologically lymph node-positive and locally advanced gastric cancer

Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy(CRT)and adjuvant chemotherapy(ChT)for T3–4/N+gastric cancer(GC)following D2/R0 dissection,and identify the specific subgroups that could benefit from adjuvant CRT.Methods All eligible patients were divided into the CRT group and ChT group.We assessed the survival outcomes and patterns of recurrence for each group,and determined the prognostic factors for survival by performing Cox proportional risk regression analyses.Results A total of 192 gastric cancer patients were included in the study.The estimated 3-year and 5-year disease-free survival(DFS)probabilities in the CRT and ChT groups were 52.9%vs.36.7%(P=0.024)and 41.2%vs.31.1%(P=0.148),respectively,and the estimated 3-year and 5-year overall survival(OS)probabilities were 82.4%vs.70.0%(P=0.044)and 52.0%vs.35.6%(P=0.022).Patients in the CRT group had a lower risk of locoregional recurrence than those in the ChT group(20.6%vs.34.4%;P=0.031).The subset analyses revealed that patients with stage N1–2 disease were more likely to benefit from adjuvant CRT than from adjuvant ChT(DFS:53.1%vs.36.4%;P=0.039;OS:53.1%vs.38.6%;P=0.036).Conclusion For locally advanced gastric cancer patients with LN+,adjuvant CRT showed superior survival benefits compared with adjuvant ChT alone.Patients with N1–2 achieved better survival from adjuvant CRT.     

苦参碱对HepG2细胞杀伤作用及机制研究

Objective:To investigate the death mode of human hepatoma cells exposed to matrine and the role of glutathione (GSH) and cytochrome c.Methods:The MTT test and Cell Death Detection ELISA were used to identify cell death mode and viability of cells exposed to matrine.The volume of intracellular GSH was detected by GSH reductase.Finally Western blotting was chosen to analyze the expression of cytochrome c and Caspase-9 in HepG2 cells treated by matrine.Results:The apoptotic cell death induced by matrine in Hep G2 cells dramatically increased in the time-,dose-dependent manner.Matrine can exhaust intracellular GSH effectively to change the redox state in cells.Furthermore it affect the cytotoxicity of matrine.Results of Western blotting showed that matrine induced the release of cytochrome c from mitochondria to cytoplasm,and then stimulate the cleavage of Cespese-9 in a time-dependent manner.Conclusion:Matrine induced apoptosis in Hep G2 cells through the mitochondrial pathway,and oxidative stress via depletion of GSH is directly involved in the apoptotic process.     

熏烤煎炸不安全

据说人类发现用火是由于森林起火烧焦了动物而引起的,从那时起,便尝到了烧烤味道的鲜美.时至今日,熏烤煎炸食品气味香,味道美,仍不免会令人垂涎三尺,颇受嘴馋的人或一些儿童、少女青睐,从而造就许多中国人有喜食这类食品的习惯.这类食品如在聚餐酒桌上品尝助兴,少量吃点在所难免,如果大量贪食则可能会对健康不利.化学家在研究癌症病因时,发现一种很强的致癌物质苯并芘,它属于多环芳烃类化合物,与熏烤煎炸食物有关,并引起人们的关注.     

肺癌放疗新技术

肺癌是危害人类生命的最主要的癌肿,是名副其实的"癌王",特别是在发达国家更是如此.简单地说美国男性死于恶性肿瘤患者中约每3人中有1例是肺癌,女性中每4人中有1人是肺癌.中国随着城市化进度的加快和吸烟人群的增多,肺癌患者会越来越多.笔者在美国最著名的癌症医院--德州安德森肿瘤中心做客座教授期间接触了来自世界各地的放疗科医生,他们都在努力研究如何延长肺癌患者的生存期,提高生存质量.下面介绍一下这方面的最新技术.     

DWI在孤立型肺结节中的应用

Objective  

The aim of our study was to investigate the value of Diffusion-weighted MR imaging (DWI) for evaluating differential diagnosis of pulmonary isolated lesions.     

Differentiation of malignant and benign lung lesions with diffusion-weighted MR imaging

Background

The aim of the study was to evaluate the role of diffusion-weighted magnetic resonance imaging in the differential diagnosis of lung lesions.

Patients and methods.

Sixty-seven patients with lung lesions (48 malignant, 19 benign) were included in this prospective study. Signal intensities (SIs) were measured in diffusion-weighted MR images that were obtained with b=0, 500 and 1000 s/mm² values. Apparent diffusion coefficient (ADC) maps were calculated by using images with b=0 and 1000 s/mm² values. The statistical significance was determined using the Student-t test.

Results

The SIs of malignant lesions were significantly higher than those of benign lesions (p<0.004 for b=0 s/mm² and p<0.000 for the other b values). Using b=500 s/mm², SI≥391 indicated a malignant lesion with a sensitivity of 95%, specificity of 73% and positive predictive value of 87%. Using b=1000 s/mm², SI≥277 indicated a malignant lesion with a sensitivity of 93%, specificity of 69% and positive predictive value of 85%. There was no significant difference between malignant and benign lesions regarding ADC values (p=0.675). There was no significant difference in SIs or ADC values between small cell carcinoma and non-small cell carcinoma. When comparing undifferentiated with well- partially differentiated cancers, SIs were higher with all b values, but the difference was statistically significant only with b=1000 s/mm² (p<0.04).

Conclusions

Diffusion-weighteted MR trace image SI is useful for the differentiation of malignant versus benign lung lesions.     

Diffusion weighted MR imaging in the differential diagnosis of haemangiomas and metastases of the liver

Background

The purpose of the study was to evaluate the value of diffusion-weighted imaging in the differential diagnosis of haemangiomas from metastases of the liver.

Patients and methods.

We analyzed 69 lesions in 38 patients (33 haemangiomas; 36 metastases) in the retrospective study. Diffusion-weighted imaging was performed using a breath-hold single-shot echo-planar spin echo sequence with three b factors (0, 500 and 1000 sec/mm²), and apparent diffusion coefficients (ADCs) were calculated. For the quantitative evaluation, signal intensity of the lesions, lesion-to-liver signal intensity ratios, ADC of the lesions, and lesion-to-liver ADC ratios were compared between the groups. The statistical significance was determined by student’s-t test.

Results

With the b factor 500 sec/mm², no statistical significance was achieved (p>0.05). With the b factor of 1000 sec/mm², both the signal intensity and lesion-to-liver signal intensity ratio of the metastases were significantly higher than those for haemangiomas (p<0.001). The cut-off value at 2.6 yielded a sensitivity of 86% and a specificity of 82% for the lesion-to-liver signal intensity ratio. The ADC, and lesion-to-liver ADC ratio of the metastases were significantly lower than those of haemangiomas (p<0.001). With cut-off value of 1.7, ADC ratio had a sensitivity of 88% and a specificity of 72% for ADC lesion/liver.

Conclusions

Diffusion-weighted imaging with high b value may help in the differential diagnosis of metastases from haemangiomas of the liver.     

Assessment of a single-pass venous phase CT chest,abdomen and pelvis and dual-energy CT in general oncology outpatients

Introduction

This study assessed replacing traditional protocol CT-arterial chest and venous abdomen and pelvis, with a single-pass, single-bolus, venous phase CT chest, abdomen and pelvis (CAP) protocol in general oncology outpatients at a single centre.

Methods

A traditional protocol is an arterial phase chest followed by venous phase abdomen and pelvis. A venous CAP (vCAP) protocol is a single acquisition 60 s after contrast injection, with optional arterial phase upper abdomen based on the primary tumour. Consecutive eligible patients were assessed, using each patient's prior study as a comparator. Attenuation for various structures, lesion conspicuity and dose were compared. Subset analysis of dual-energy (DE) CT scans in the vCAP protocol performed for lesion conspicuity on 50 keV virtual monoenergetic (VME) images.

Results

One hundred and eleven patients were assessed with both protocols. Forty-six patients had their vCAP scans using DECT. The vCAP protocol had no significant difference in the attenuation of abdominal structures, with reduced attenuation of mediastinal structures. There was a significant improvement in the visibility of pleural lesions (p < 0.001), a trend for improved mediastinal nodes assessment, and no significant difference for abdominal lesions. A significant increase in liver lesion conspicuity on 50 keV VME reconstructions was noted for both readers (p < 0.001). There were significant dose reductions with the vCAP protocol.

Conclusion

A single-pass vCAP protocol offered an improved thoracic assessment with no loss of abdominal diagnostic confidence and significant dose reductions compared to traditional protocol. Improved liver lesion conspicuity on 50 keV VME images across a range of cancers is promising.     

Integrating diffusion kurtosis imaging,dynamic susceptibility-weighted contrast-enhanced MRI,and short echo time chemical shift imaging for grading gliomas

Background

We assessed the diagnostic accuracy of diffusion kurtosis imaging (DKI), dynamic susceptibility-weighted contrast-enhanced (DSC) MRI, and short echo time chemical shift imaging (CSI) for grading gliomas.

Methods

In this prospective study, 35 patients with cerebral gliomas underwent DKI, DSC, and CSI on a 3 T MR scanner. Diffusion parameters were mean diffusivity (MD), fractional anisotropy, and mean kurtosis (MK). Perfusion parameters were mean relative regional cerebral blood volume (rrCBV), mean relative regional cerebral blood flow (rrCBF), mean transit time, and relative decrease ratio (rDR). The diffusion and perfusion parameters along with 12 CSI metabolite ratios were compared among 22 high-grade gliomas and 14 low-grade gliomas (Mann–Whitney U-test, P < .05). Classification accuracy was determined with a linear discriminant analysis for each MR modality independently. Furthermore, the performance of a multimodal analysis is reported, using a decision-tree rule combining the statistically significant DKI, DSC-MRI, and CSI parameters with the lowest P-value. The proposed classifiers were validated on a set of subsequently acquired data from 19 clinical patients.

Results

Statistically significant differences among tumor grades were shown for MK, MD, mean rrCBV, mean rrCBF, rDR, lipids over total choline, lipids over creatine, sum of myo-inositol, and sum of creatine. DSC-MRI proved to be the modality with the best performance when comparing modalities individually, while the multimodal decision tree proved to be most accurate in predicting tumor grade, with a performance of 86%.

Conclusions

Combining information from DKI, DSC-MRI, and CSI increases diagnostic accuracy to differentiate low- from high-grade gliomas, possibly providing diagnosis for the individual patient.     

Correlation of diffusion MRI with the Ki-67 index in non-small cell lung cancer

Background

The primary objective of the study was to evaluate the association between the minimum apparent diffusion coefficient (ADC_min) and Ki-67, an index for cellular proliferation, in non-small cell lung cancers. Also, we aimed to assess whether ADC_min values differ between tumour subtypes and tissue sampling method.

Methods

The patients who had diffusion weighted magnetic resonance imaging (DW-MRI) were enrolled retrospectively. The correlation between ADC_min and the Ki-67 index was evaluated.

Results

Ninety three patients, with a mean age 65 ± 11 years, with histopathologically proven adenocarcinoma and squamous cell carcinoma of the lungs and had technically successful DW-MRI were included in the study. The numbers of tumour subtypes were 47 for adenocarcinoma and 46 for squamous cell carcinoma. There was a good negative correlation between ADC_min values and the Ki-67 proliferation index (r = −0.837, p < 0.001). The mean ADC_min value was higher and the mean Ki-67 index was lower in adenocarcinomas compared to squamous cell carcinoma (p < 0.0001). There was no statistical difference between tissue sampling methods.

Conclusions

Because ADC_min shows a good but negative correlation with Ki-67 index, it provides an opportunity to evaluate tumours and their aggressiveness and may be helpful in the differentiation of subtypes non-invasively.     

Challenges for the functional diffusion map in pediatric brain tumors

Background

The functional diffusion map (fDM) has been suggested as a tool for early detection of tumor treatment efficacy. We aim to study 3 factors that could act as potential confounders in the fDM: areas of necrosis, tumor grade, and change in tumor size.

Methods

Thirty-four pediatric patients with brain tumors were enrolled in a retrospective study, approved by the local ethics committee, to examine the fDM. Tumors were selected to encompass a range of types and grades. A qualitative analysis was carried out to compare how fDM findings may be affected by each of the 3 confounders by comparing fDM findings to clinical image reports.

Results

Results show that the fDM in areas of necrosis do not discriminate between treatment response and tumor progression. Furthermore, tumor grade alters the behavior of the fDM: a decrease in apparent diffusion coefficient (ADC) is a sign of tumor progression in high-grade tumors and treatment response in low-grade tumors. Our results also suggest using only tumor area overlap between the 2 time points analyzed for the fDM in tumors of varying size.

Conclusions

Interpretation of fDM results needs to take into account the underlying biology of both tumor and healthy tissue. Careful interpretation of the results is required with due consideration to areas of necrosis, tumor grade, and change in tumor size.     

Global diffusion tensor imaging derived metrics differentiate glioblastoma multiforme vs. normal brains by using discriminant analysis: introduction of a novel whole-brain approach

Background

Histological behavior of glioblastoma multiforme suggests it would benefit more from a global rather than regional evaluation. A global (whole-brain) calculation of diffusion tensor imaging (DTI) derived tensor metrics offers a valid method to detect the integrity of white matter structures without missing infiltrated brain areas not seen in conventional sequences. In this study we calculated a predictive model of brain infiltration in patients with glioblastoma using global tensor metrics.

Methods

Retrospective, case and control study; 11 global DTI-derived tensor metrics were calculated in 27 patients with glioblastoma multiforme and 34 controls: mean diffusivity, fractional anisotropy, pure isotropic diffusion, pure anisotropic diffusion, the total magnitude of the diffusion tensor, linear tensor, planar tensor, spherical tensor, relative anisotropy, axial diffusivity and radial diffusivity. The multivariate discriminant analysis of these variables (including age) with a diagnostic test evaluation was performed.

Results

The simultaneous analysis of 732 measures from 12 continuous variables in 61 subjects revealed one discriminant model that significantly differentiated normal brains and brains with glioblastoma: Wilks’ λ = 0.324, χ² (3) = 38.907, p < .001. The overall predictive accuracy was 92.7%.

Conclusions

We present a phase II study introducing a novel global approach using DTI-derived biomarkers of brain impairment. The final predictive model selected only three metrics: axial diffusivity, spherical tensor and linear tensor. These metrics might be clinically applied for diagnosis, follow-up, and the study of other neurological diseases.     

Clinical value of whole-body magnetic resonance imaging in health screening of general adult population

Background

Whole-body magnetic resonance imaging (WB-MRI) and angiography (WB-MRA) has become increasingly popular in population-based research. We evaluated retrospectively the frequency of potentially relevant incidental findings throughout the body.

Materials and methods

22 highly health-conscious managers (18 men, mean age 47±9 years) underwent WB-MRI and WB-MRA between March 2012 and September 2013 on a Discovery MR750w wide bore 3 Tesla device (GE Healthcare) using T1 weighted, short tau inversion recovery (STIR) and diffusion weighted imaging (DWI) acquisitions according to a standardized protocol.

Results

A suspicious (pararectal) malignancy was detected in one patient which was confirmed by an endorectal sonography. Incidental findings were described in 20 subjects, including hydrocele (11 patients), benign bony lesion (7 patients) and non-specific lymph nodes (5 patients). Further investigations were recommended in 68% (ultrasound: 36%, computed tomography: 28%, mammography: 9%, additional MRI: 9%). WB-MRA were negative in 16 subjects. Vascular normal variations were reported in 23%, and a 40% left proximal common carotid artery stenosis were described in one subject.

Conclusions

WB-MRI and MRA lead to the detection of clinically relevant diseases and unexpected findings in a cohort of healthy adults that require further imaging or surveillance in 68%. WB-MR imaging may play a paramount role in health screening, especially in the future generation of (epi)genetic based screening of malignant and atherosclerotic disorders. Our study is the first which involved a highly selected patient group using a high field 3-T wide bore magnet system with T1, STIR, MRA and whole-body DWI acquisitions as well.     

Real-time intraoperative detection of breast cancer using near-infrared fluorescence imaging and Methylene Blue

Background

Despite recent developments in preoperative breast cancer imaging, intraoperative localization of tumor tissue can be challenging, resulting in tumor-positive resection margins during breast conserving surgery. Based on certain physicochemical similarities between Technetium(^99mTc)-sestamibi (MIBI), an SPECT radiodiagnostic with a sensitivity of 83–90% to detect breast cancer preoperatively, and the near-infrared (NIR) fluorophore Methylene Blue (MB), we hypothesized that MB might detect breast cancer intraoperatively using NIR fluorescence imaging.

Methods

Twenty-four patients with breast cancer, planned for surgical resection, were included. Patients were divided in 2 administration groups, which differed with respect to the timing of MB administration. N = 12 patients per group were administered 1.0 mg/kg MB intravenously either immediately or 3 h before surgery. The mini-FLARE imaging system was used to identify the NIR fluorescent signal during surgery and on post-resected specimens transferred to the pathology department. Results were confirmed by NIR fluorescence microscopy.

Results

20/24 (83%) of breast tumors (carcinoma in N = 21 and ductal carcinoma in situ in N = 3) were identified in the resected specimen using NIR fluorescence imaging. Patients with non-detectable tumors were significantly older. No significant relation to receptor status or tumor grade was seen. Overall tumor-to-background ratio (TBR) was 2.4 ± 0.8. There was no significant difference between TBR and background signal between administration groups. In 2/4 patients with positive resection margins, breast cancer tissue identified in the wound bed during surgery would have changed surgical management. Histology confirmed the concordance of fluorescence signal and tumor tissue.

Conclusions

This feasibility study demonstrated an overall breast cancer identification rate using MB of 83%, with real-time intraoperative guidance having the potential to alter patient management.