40 years of progress in chemotherapy

The history of medical oncology's history is exemplary for the rapidity of its evolution and its therapeutic acquisitions; Chemotherapy contributes to modify the natural history of the majority of cancers. The development of clinical research in medical oncology has entered a conflict phase, where patients have become an economical stake. The necessary co-operation between oncologists, other medical specialists, the basic scientists and competent regulatory authorities should be treated as a trump card in the attempt to exit from the current mid-life crisis of our specialty.     

Implications of pathologist concordance for breast cancer assessments in mammography screening from age 40 years

Three pathologists reviewed slides and reports of cancers arising in both the study and control populations of the U.K. trial of annual mammography screening from age 40 years. A total of 875 cases were scored independently as noninvasive, microinvasive, or invasive cancer, with the last also evaluated for histology grade, type, and lymphatic vascular invasion. Of these, 870 (99.2%) were confirmed malignant, 1 case had cytology only, and 5 were judged by all reviewers as benign. Reviewer complete concordance for the three classes of malignancy was achieved in 826 (95%) and majority agreement in 31 (3.6%) of 870 with complete data. All three readers recorded grade in 736 cancers, giving a kappa statistic of 0.69, 0.52, and 0.66 for grades I, II, and III, respectively, and 0.61 overall. Agreement that the cancer was special type or not was obtained in 671 (89.0%) with complete concordance in the nature of the type in 504 and majority view in 167; another 58 (7.7%) were characterised as "part special" pattern, with type disagreement in 23 (3%). The kappa statistic for single type subcategories in those cancers was substantial, at 0.68 overall. This improved to 0.76 for the last 230 invasive cancers after the pathologists agreed more explicit criteria for type discrimination. There was almost perfect agreement between original and review diagnosis of breast malignancy for both noninvasive/microinvasive and invasive cancer (kappa 0.84 and 0.91, respectively), justifying confidence in the diagnosis of breast cancer by U.K. pathologists. The specialists agreed substantially on qualitative histology features of type and grade of cancers, and improved further for typing by defining criteria. These consensus data, along with invasive size and node status, are reliable for use as surrogate measures of outcome, and to enhance interpretation of effect, when the trial case population sources are disclosed.     

新型冠状病毒肺炎的影像学应用及进展

新型冠状病毒肺炎（Corona Virus Disease 2019, COVID-19）引起了全球大规模疫情,其影像学表现多种多样且变化迅速,本文从影像学在COVID-19的诊断、分期分型、随访方面的应用进展及人工智能在COVID-19影像诊断方面的研究进展进行综述。     

Oocyte donation in menopausal women aged over 40 years

In order to investigate the pregnancy potential of menopausalwomen over 40 years of age by use of donor eggs, we retrospectivelyanalysed the results of our ovum donation programme. Forty-oneclinical pregnancies were established in 134 recipient cycles.The recipients were divided into three age groups (40–43,44–47 and 48 years) in order to investigate the implantationrate with respect to age. The 30.6% pregnancy rate per embryotransfer cycle and 9.7% implantation rate per embryo appearedto be constant in all age groups studied. Fourteen pregnanciesended in miscarriage, there was one ectopic pregnancy and 25healthy babies have been delivered. The oldest woman to deliverwas 54 years of age. This report highlights the question ofage limit for application of the new reproductive technologies,and especially of oocyte donation.