乳腺癌1%异硫蓝哨兵淋巴结活检的临床研究

目的 探讨采用1％异硫蓝(1％ isosulfan blue，IB)行乳腺癌哨兵淋巴结活检(sentinel lymph node biopsy，SLNB)的可行性、准确性及其临床价值。方法80例T1、T2乳腺恶性肿瘤患，全身麻醉后，取1％异硫蓝5ml随机注人乳晕或肿瘤周围，注射后5min取腋窝切口长5cm，尽量在无血操作下切开腋筋膜仔细解剖，沿蓝色的淋巴管寻找着色的淋巴结即哨兵淋巴结(sentinel lymphnode，SLN)，然后行SLNB，再行腋窝淋巴结解剖(axillary lymph nodes dissection，ALND)，并将全部标本送病理检查。结果 全组80例行SLNB中有7例没有发现SLN，3例为假阴性，SLN检出率为91．25％，灵敏度为84．38％，准确率87．5％；假阴性率9．38％；假阳性率为0。结论 采用1％异硫蓝行SLNB具有费用低，操作简便，经过认真训练，可明显提高单独采用染料行SLNB的准确率和灵敏度，在将来选择性地进行ALND中可能具有广泛的临床应用前景。     

乳腺癌改良根治术美蓝法前哨淋巴结定位活检的临床意义

目的：探讨美蓝法乳腺癌前哨淋巴结活检（SLNB）的临床意义。方法：选择乳腺癌患者75例,取1％美蓝4ml注射于肿瘤周围后行SLNB,然后行乳腺癌改良根治术。结果：前哨淋巴结（SLN）检出成功率为100．0％（75／75）;准确率为97．3％（73／75）,灵敏度为97．2％（36／37）,假阴性率为2．7％（1／37）。发生并发症4例（5．4％）,经随访患者均无腋窝淋巴结复发和远处转移。结论：美蓝作为指示剂行前哨淋巴结活检术,价格低廉、简便易行,但长期的临床价值及可行性尚需进一步探讨和证实。     

99Tcm硫胶体联合美蓝在乳腺癌前哨淋巴结活检中的临床应用价值

目的 探讨99Tcm硫胶体(99Tcm-sulfur colloid,99Tcm-SC)联合美蓝在早期乳腺癌前哨淋巴结活检(SLNB)中的可行性、准确性及临床应用价值.方法 采用99Tcm-SC联合美蓝对76例T1～ 2N0M0乳腺癌患者进行SLNB,将切除的前哨淋巴结行病理检查了解其符合率,探讨联合法在早期乳腺癌SLNB中的临床应用价值.结果 成功确定患者前哨淋巴结76例,7例前哨淋巴结病理检测阳性并行腋窝淋巴结清扫,99Tcm-SC灵敏度为85.7％ (6/7),准确性为98.7％( 75/76),假阴性率为14.3％( 1/7),美蓝法灵敏度为71.4％ (5/7),准确性为97.4％ (74/76),假阴性率为28.6％ (2/7).联合法灵敏度、准确性为100.0％(7/7,76/76),假阳性率为0(0/7).结论 99Tcm-SC联合美蓝可明显降低早期乳腺癌SLNB的假阴性率.     

亚甲蓝和纳米炭混悬液在乳腺癌前哨淋巴结活检中的临床应用

目的:比较亚甲蓝和纳米炭混悬液行乳腺癌前哨淋巴结活检(sentinel lymph nodes biopsy,SLNB)的成功率及临床值.方法:从2007年5月我院收治乳腺癌患者中抽取86例(T1 T2),按注射染料的类型不同随机分为亚甲蓝组和纳米炭混悬液组,其中亚甲蓝组44例和纳米炭混悬液组42例.染料被分4点注入,乳晕周围皮下和乳腺组织中.30分钟后行前哨淋巴结活检术,再行腋窝淋巴结清扫术,并将前哨淋巴结及腋窝淋巴结送病理检查.结果:亚甲蓝组44例检出前哨淋巴结(Sentiel Lymph Nodes,SLN)41例(91.18％),SLNB的灵敏度为92.31％(12/13),准确率为90.91％(40/44),假阴性率为7.69％(1/13),假阳性率为0.纳米炭混悬液组42例,检出SLN40例(95.24％),SLNB的灵敏度为91.67％(11/12),准确率为92.86％(39/42),假阴性率为8.33％(1/12),假阳性率为0.两组间差异无显著性(P＞0.05).结论:采用亚甲蓝行乳腺癌SLNB的准确率和灵敏度与纳米炭混悬液相当,而亚甲蓝费用低廉更具有临床应用前景.     

早期乳腺癌前哨淋巴结的临床研究

目的 研究早期乳腺癌前哨淋巴结活检（sentinel lymph node biopsy，SLNB）的必要性、可行性、准确性及临床应用价值。方法 采用活性蓝对32例T1-2N0M0乳腺癌患者进行SLNB。随后常规行腋窝淋巴结清扫（axillary lymph node dissection，ALND），将切除的前哨淋巴结（SLN）和腋窝淋巴结（ALN）同时送病理检查，了解其符合率，探讨SLNB在早期乳腺癌中的临床应用价值。结果 成功确定患者SLN31例，成功率为96．9％（31／32）；SLN阳性9例（29．0％），SLN阴性22例（70％）；ALN阳性10例（31．3％），ALN阴性22例（68．8％）；SLNB的灵敏度为90．0％，准确性为93．8％，假阴性率为10．0％，假阳性率为0。结论 SLNB可以准确地预测早期乳腺癌患者ALN的组织学特征，利用活性蓝作为显示剂可以提高SLNB的成功率。     

亚甲蓝示踪法在乳腺癌前哨淋巴结活检中的临床应用

目的探讨亚甲蓝(MB)示踪法在乳腺癌前哨淋巴结活检(SLNB)中的临床应用价值。方法选择临床T1-2N0-1M0乳腺癌患者96例,用MB示踪法进行SLNB,而后行腋窝淋巴结清扫术(ALND)。前哨淋巴结(SLN)行冰冻切片病理,术后SLN及非前哨淋巴结(nSLN)均行HE染色进行病理观察。结果 SLN检出率96.9%(93/96)。93例SLN冰冻切片阳性54例,阴性39例。HE染色SLN阳性56例,阴性37例,nSLN阳性22例,其中20例SLN同时阳性,2例阴性,即SLN假阴性2例。SLN冰冻切片与HE染色病理诊断的符合率为97.9%(91/93)。按照HE染色病理检查计算,SLN预测腋窝淋巴结(ALN)状态的假阴性率3.5%(2/58),敏感度96.6%(56/58),准确性97.9%(91/93),阳性预测值100%(56/56),阴性预测值94.6%(35/37)。结论单用MB示踪法行乳腺癌SLNB的检出率及敏感性较高,且经济实用,适宜在广大基层医院推广应用。     

乳腺癌化疗后前哨淋巴结活检术的临床探讨

目的探讨乳腺癌化疗后前哨淋巴结活检术（SLNB）的准确性及临床意义。方法用美蓝作为示踪剂，对90例临床分期为Ⅱ、Ⅲ期，并已行化疗后临床检查腋窝淋巴结阴性的乳腺癌患者进行SLNB，术中均同时行腋窝淋巴结清扫术。结果90例中前哨淋巴结成功检出82例，检出率91．1％。每例检出前哨淋巴结的数量为1～4枚，平均1．6枚。82例前哨淋巴结成功检出的患者中。45例患者有腋窝淋巴结转移，其中前哨淋巴结有转移者40例，前哨淋巴结未发现转移而非前哨淋巴结有转移者5例，8例只有前哨淋巴结为阳性淋巴结，前哨淋巴结预测腋窝淋巴结状态准确率为93．9％（77／82）。灵敏度为88．9％（40／45），阳性预测值为100％，阴性预测值为88．1％，假阴性率为11．1％（5／45）。原发肿瘤为T2、T3／T4组检出率分别为96．1％（49／51）、84．6％（33／39）；假阴性率分别为5．3％（1／19）、15．4％（4／26），差异无统计学意义。肿瘤对化疗反应为完全缓解（CR）、部分缓解（PR）、稳定（SD）的前哨淋巴结检出率分别为92．3％、93．1％、84．2％，差异无统计学意义；假阴性5例均发生在PR、SD患者。结论化疗后腋窝淋巴结阴性的Ⅱ、Ⅲ期乳腺癌患者，行SLNB可获得与早期未行新辅助化疗乳腺癌SLNB相似的结果；化疗前原发肿瘤为T2的乳腺癌患者，SLNB能较准确预测腋窝淋巴结的状态。     

用亚甲蓝判定乳腺癌前哨淋巴结转移的临床应用

目的以亚甲蓝为示踪剂探测乳腺癌前哨淋巴结(sentinel lymph node,SLN),评价前哨淋巴结预测腋窝淋巴结转移的准确性。方法研究对象为自2011年6月份起我院普外科收治的100例cTis³N03N0²M0的乳腺癌患者。使用亚甲蓝为示踪剂,进行前哨淋巴结活检,之后行腋窝清扫。结果 91例患者中成功地发现了SLN,SLN的数量为201个,平均每例2.20个。SLNB的灵敏度91.00%(91/100),准确率96.70%(88/91),假阴性率5.66%(3/53),阳性预测值为100%。结论使用亚甲蓝作为示踪剂能准确找到前哨淋巴结,并能较好的预测腋窝淋巴结转移情况。     

乳腺癌前哨淋巴结活组织检查16例临床研究

目的:探讨检测乳腺癌前哨淋巴结(SLN)的方法,研究前哨淋巴结活组织检查(SLNB)预测腋窝淋巴结状况的准确性。方法:对16例乳腺癌患者行美蓝染色法检测SLN ,并行腋窝淋巴结清扫术(ALND)后,将腋窝淋巴结转移状况与SLN进行对比,分析SLN检出率。结果:16例患者检测出SLN 13例,成功率81.2 5 % ,检出SLN2 9个,平均每例检出1.812 5个。13例中,6例SLN阳性,阳性率4 6 .15 % ,1例出现假阴性,假阴性率6 .2 5 % ,SLNB预测腋窝淋巴结(ALN)的敏感性为87.1% ,准确率为95 .6 %。结论:SLND可以较准确预测乳腺癌患者腋窝淋巴结的转移状况     

亚甲蓝在保乳术前哨淋巴结活检中的应用

目的 探讨亚甲蓝染色在乳腺癌保乳术前哨淋巴结活检（SLNB）中的应用价值.方法 55例临床Ⅰ～Ⅱ期乳腺癌患者,行亚甲蓝染色定位前哨淋巴结（SLN）,SLNB并腋窝淋巴结清扫（ALND）,对全部的SLN和腋窝淋巴结行病理检查并分析结果.结果 55例中成功检出SLN 52例,检出率95%,SLNB的灵敏度为100%（20/20）,准确率为93%（52/55）,假阴性率为5%（1/20）,假阳性率为0.结论 亚甲蓝染色是乳腺癌前哨淋巴结活检的可靠方法,SLNB是一种简便、安全的检测技术,可用于了解腋窝淋巴结的状况.     

Mutagenicity studies on two triphenylmethane dyes, bromophenol blue and tetrabromophenol blue.

Bromophenol blue and tetrabromophenol blue are two triphenylmethane dyes. Triphenylmethane derivatives and their structurally related compounds, such as fluoresceins and xathenes, are widely used as industrial dyes for foods, drugs, cosmetics, textiles, printing inks or laboratory indicators. Since a number of these types of dyes have been reported to be genotoxic, safety concerns on these two dyes of interest have been raised. Consequently, a battery of genetic toxicology assays, including the Ames Salmonella/microsome assay, L5178Y TK+/- mouse lymphoma assay, mouse micronucleus test and mitotic recombination assay with yeast Saccharomyces cerevisiae strain D5, has been performed on each of the two dyes. The results of the evaluations indicate that both bromophenol blue and tetrabromophenol blue were not active and can be considered non-genotoxic for the three genetic endpoints assessed (gene mutation, chromosome aberrations and primary DNA damage). Genetic activities in some structurally related compounds of these dyes have been reported but may be attributed to the presence of mutagenic impurities rather than the compound itself.     

Methylene blue and Alzheimer's disease

The relationship between methylene blue (MB) and Alzheimer's disease (AD) has recently attracted increasing scientific attention since it has been suggested that MB may slow down the progression of this disease. In fact, MB, in addition to its well characterized inhibitory actions on the cGMP pathway, affects numerous cellular and molecular events closely related to the progression of AD. Currently, MB has been shown to attenuate the formations of amyloid plaques and neurofibrillary tangles, and to partially repair impairments in mitochondrial function and cellular metabolism. Furthermore, various neurotransmitter systems (cholinergic, serotonergic and glutamatergic), believed to play important roles in the pathogenesis of AD and other cognitive disorders, are also influenced by MB. Recent studies suggest that the combination of diverse actions of MB on these cellular functions is likely to mediate potential beneficial effects of MB. This has lead to attempts to develop novel MB-based treatment modalities for AD. In this review article, actions of MB on neurotransmitter systems and multiple cellular and molecular targets are summarized with regard to their relevance to AD.     

美蓝的抗肿瘤作用

美蓝 (Ｍｅｔｈｙｌｅｎｅｂｌｕｅ ,ＭＢ)原为解毒药物 ,近年发现有抗肿瘤作用 ,临床报道将其在肿瘤部位直接介入治疗实体及腹水肿瘤[1～ 3 ] 。为确定美蓝的抗癌范围及为临床应用提供实验依据 ,我们对美蓝的抗肿瘤作用作了以下研究。1　实验材料与方法1.1　材料1.1.1　动物　昆明小鼠 ,18～ 2 2ｇ ,河南省实验动物中心提供 ,合格证号 0 0 112。1.1.2 　瘤株　Ｓ180 、ＥＡＣ、ＨｅｐＡ ,均由北京中国医学科学院药物研究所肿瘤室提供。1.1.3　试剂　美蓝 ,上海试剂三厂生产 ,批号 990 0 90 8。 5 Ｆｕ ,天津化工院赠。1.2　方法　按全国肿…     

Pigment molecules linked to polymer support: blue rayon, blue chitin, and green chitosan-synthesis and applications

The fact that hemin can inhibit the mutagenic activity of compounds bearing polycyclic structures is ascribable to the ability of the porphyrin structure to complex with the planar surface of the mutagens. The elucidation of this mechanism has led to the discovery of copper phthalocyanine trisulfonate (cpt) as an efficient ligand to trap polycyclic compounds on polymeric supports that bear cpt through covalent bond linkages. In blue cotton, the support for cpt is cotton, in blue rayon, it is amorphous rayon, and in blue chitin it is poly-N-acetylglucosamine. Using these blue materials, we have successfully isolated mutagens of polycyclic structures, e.g., heterocyclic amines, from environmental complex mixtures such as food, urine, feces, and river water. Preparation and properties of these adsorbents are described. Chlorophyllin linked to Sepharose and chitosan is also described. The use of these green materials is discussed.