人表皮生长因子受体3在乳腺癌组织中的表达及临床意义

目的探讨人表皮生长因子受体(HER)3基因在乳腺癌组织中的表达及其与临床病理学特征和预后的相关性。方法采用免疫组织化学法检测126例乳腺癌组织中HER3的表达,分析其表达与患者年龄、月经情况、TNM分期、肿瘤大小、淋巴结转移、雌激素受体(ER)、孕激素受体(PR)、HER2及预后的关系。结果 (1)乳腺癌组织中HER3的阳性表达率为30.2%。HER3阳性表达在乳腺癌绝经患者中占43.3%,高于未绝经者的18.2%(P0.05);淋巴结转移阳性的乳腺癌患者HER3阳性表达率为40.0%,高于无淋巴结转移患者的21.2%,差异有统计学意义(P0.05);HER2阳性的乳腺癌患者HER3阳性表达率为42.5%,高于HER2阴性者的24.4%,差异有统计学意义(P0.05)。(2)HER3阳性患者的五年无病生存率更低(P0.05)。(3)HER3与HER2均阳性的乳腺癌患者淋巴结转移率较高(P0.05)。结论 HER3的表达可能在乳腺癌的发生和发展过程中起重要作用,并影响其预后,HER3可能成为判断乳腺癌预后的指标及临床治疗的靶点。     

表皮生长因子受体2和雌激素受体及孕激素受体在乳腺癌中的表达及相关性分析

目的 探讨表皮生长因子受体2(HER2)和雌激素受体(ER)及孕激素受体(PR)在乳腺癌中的表达及相关性,并提出HER2 检测的优化程序,从而有利于HER2 检测的准确性和可重复性,更准确地筛选出适用Herceptin 靶向基因治疗的患者.方法 免疫组织化学SP 三步法对113 例广东地区乳腺癌患者HER2 、ER 、PR 表达进行检测.结果 在本组113 例乳腺癌患者中HER2 表达的阳性率为24.78 %,ER 表达的阳性率为61.95 %,PR 表达的阳性率为67.26 %,HER2 表达与乳腺癌TNM 分期、患者年龄、淋巴结转移、肿瘤大小无关(P ＞0.05 );HER2 表达与ER 、PR 表达情况有关(P ＜0.01 ),且呈负相关.结论 广东地区女性乳腺癌HER2 和ER 及PR 之间的表达相互关联,并在乳腺癌的确定治疗对策中扮演着重要角色.HER2检测的准确性和重复性,有赖于如何优化HER2 状况检测程序.     

乳腺癌HER-2基因与雌激素和孕激素受体的关系及意义

目的 :探讨HER - 2、ER和PR在乳腺癌中的表达及临床意义。方法 :免疫组织化学检测 16 7例乳腺癌组织中HER - 2、ER和PR的表达情况 ,并进行统计分析。结果 :HER - 2、ER和PR在乳腺癌组织中的阳性表达率分别为 4 4 9% (75 / 16 7)、 5 3 3% (89/ 16 7)和 4 9 1% (82 / 16 7)。HER - 2表达 :在ER和PR均为阳性组HER- 2阳性表达率中低于ER和PR均为阴性组 (P <0 0 5 ) ,在有淋巴结转移组中HER - 2阳性表达率高于淋巴结未转移组 (P <0 0 5 )。结论 :联合检测HER - 2、ER和PR ,对于乳腺癌的治疗具有指导意义 ,也是判断预后的重要指标。     

乳腺癌组织中CerbB-2、ER与PR表达以及对预后的影响

目的 观察乳腺癌患者CerbB-2、雌激素受体(ER)、孕激素受体(PR)表达与其他临床预后因素的相关性,以及对预后的影响.方法 选择我院确诊并行乳腺癌根治术或改良根治术80例,采用免疫组织化学技术s-p法检测手术切除标本乳腺癌组织中CerbB-2、ER、PR的表达状况,并分析其与乳腺癌淋巴结转移及复发间的关系.结果CerbB-2在ER、PR均阳性组的表达低于两者均阴性组的表达(P＜0.05).ER与PR的阳性表达与腋淋巴结转移及复发呈负相关(P＜0.05);CerbB-2的阳性表达与腋淋巴结转移及复发呈正相关(P＜0.05).结论 乳腺癌组织中CerbB-2、ER、PR的表达具有相关性,且CerbB-2、ER、PR的表达与淋巴结转移及乳腺癌预后密切相关,联合检测三项指标可用以指导乳腺癌的临床治疗和预后判断.     

ER、PR和HER-2检测对乳腺癌临床治疗及预后判断的意义

目的 探讨免疫组化检查(IHC)对乳腺癌组织中雌激素受体(ER)、孕激素受体(PR)、C-erbB-2表达与乳腺癌临床治疗及预后判断的意义.方法 收集本院88例乳腺癌临床病理学资料,进行常规HE切片及ER、PR检查,采用Elivision法分别测定88例乳腺癌组织ER、PR、C-erbB-2的表达,有条件的病例作FISH检测,并与FISH进行比较;同时评估IHC对乳腺癌ER、PR、C-erbB-2表达情况,复习相关文献资料,研究乳腺癌ER、PR及HER2等检测与临床预后意义.结果 在88例乳腺癌中病免疫病理检查结果显示:ER约60%呈阳性反应,c-erbB-2约26%阳性.结论 结合免疫组化表达进行综合分析,对提高乳腺癌的诊断及预后判断,指导临床治疗方案有明显的临床意义.     

浸润性乳腺癌细胞学分级及其与激素受体等表达的关系

目的 探讨浸润性乳腺癌细胞分级的临床意义及其与雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子2(HER2)表达的关系.方法 对细针吸取细胞学(FNAC)诊断为"高度癌疑"及"乳腺癌"的47例细胞学标本进行细胞学分级,并采用免疫细胞化学方法检测细针吸取乳腺癌细胞ER、PR、HER2的表达,应用卡方检验对免疫细胞化学染色结果与术后免疫组织化学染色结果进行统计学分析,应用spearman相关分析对细胞学分级与ER、PR及HER2的表达关系进行统计学分析.结果 (1)术前穿刺涂片诊断为"高度可疑乳腺癌"及"乳腺癌"的47例女性患者,经术后病理组织学证实均为乳腺癌,细胞学诊断准确率为100%.其中1级13例,2级19例,3级15例.(2)利用免疫细胞化学染色对术前细针吸取细胞标本ER、PR及HER2表达进行检测,其阳性率分别为为55.32%、53.19%及19.15%.相对应的石蜡切片经免疫组织化学染色检测,ER、PR及HER2的表达阳性率55.32%、55.32%及17.02%.两种染色方法结果经卡方检验,差异无统计学意义(P>0.05).(3)术前乳腺癌细胞学分级与ER、PR的表达呈负相关(P＜0.01),与HER2的表达呈正相关(P＜0.01).结论 FNA是术前诊断乳腺癌准确、易行的方法之一.乳腺癌术前细针吸取细胞学分级联合免疫细胞化学染色可在术前提供更多肿瘤的相关信息,可能成为指导术前新辅助化疗、术式选择的有用指标.     

乳腺癌动态增强磁共振成像特征与分子预后标志物的关系

目的:探讨乳腺癌动态增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)特征与分子预后标志物的关系。方法:回顾性分析68例乳腺癌患者术前DCE-MRI图像特征,比较不同分子预后标志物表达情况的DCE-MRI图像特征差异。结果:与雌激素受体(estrogen receptor,ER)阳性者比较,ER阴性者大肿块病灶(直径≥2 cm)、病灶边缘光整的比例明显升高(χ~2=4.55,8.27;P0.05);与孕激素受体(progesteronereceptor,PR)阳性者比较,PR阴性者病灶边缘光整的比例明显升高(χ~2=7.23;P0.05);与人类表皮生长因子受体-2(human epidermal growth factor receptor-2,HER2)阳性者比较,HER2阴性者大肿块病灶的比例明显降低(χ~2=4.57;P0.05);与Ki-67阳性者比较,Ki-67阴性者大肿块病灶、病灶边缘光整的比例明显降低(χ~2=4.72,7.88;P0.05)。乳腺癌患者MRI达峰时间为(203.15±15.46)s,早期强化率为(125.17±18.24)%。达峰时间与ER、PR阳性表达呈正相关(r=0.388,0.359;P0.05),与HER2表达、Ki-67标记指数均无显著相关性(r=-0.281,-0.310;P0.05)。结论:乳腺癌DCE-MRI图像特征,尤其是肿瘤大小、边缘状态及早期强化率,与PR、ER、HER2表达及Ki-67标记指数具有良好相关性,可为乳腺癌患者术前预测、治疗方案的制定及预后评估提供参考依据。     

雌激素受体β在乳腺癌中的表达

目的:探讨雌激素受体(ERβ)在乳腺癌表达情况以及其与乳腺癌的关系.方法:选取经根治性手术治疗的乳腺癌患者52例为研究对象.采用免疫组织化学法测定乳腺癌组织中ERβ的表达.根据ERβ表达情况将患者分成ERβ阳性组和阴性组,并结合临床病理指标和生物学指示作对比分析.结果:ERβ表达与Ki67表达负相关(P=0.019),ERβ蛋白的表达与月经状况,肿瘤大小, TNM分期,组织学类型无关,与其他生物学指标P53、C-erbB-2和GST-π表达无关.结论:ERβ表达状况对乳腺癌患者预后的判断有一定价值,为独立的预后影响因素.     

TogoⅡ蛋白在原发性乳腺癌组织中的表达及其与预后的相关性

目的 探讨DNA拓扑异构酶Ⅱ(TopoⅡ)蛋白在原发性乳腺癌组织中的表达及其与预后的相关性。方法选择经术后病理证实的原发性乳腺癌患者100例,采用免疫组织化学SP法检测乳腺癌组织中TopoⅡ、雌激素受体(ER)、孕激素受体(PR)、p53的表达情况,分析TopoⅡ蛋白与临床病理特征的关系及其与ER、PR、p53和预后的相关性。结果 100例患者乳腺癌组织中TopoⅡ蛋白阳性表达率为58.00%,明显高于ER、PR、p53的38.00%、35.00%、27.00%(P<0.05)。有淋巴结转移的TopoⅡ蛋白阳性表达率为84.21%,明显高于无淋巴结转移的41.94%(P<0.05)。TopoⅡ蛋白阳性表达与淋巴结转移和ER、PR、p53表达均呈正相关(r=0.947、0.785、0.627、0.468,均P<0.05)。结论 TopoⅡ蛋白在原发性乳腺癌组织中可高表达,可能为评估乳腺癌患者预后的指标之一。 更多还原     

磷酸化蛋白50在乳腺癌中的表达及意义

目的:探讨抑癌基因磷酸化蛋白(EBP50)在乳腺癌中的表达及临床意义.方法:应用免疫组织化学方法检测53例乳腺癌EBP50的表达.结果:EBP50在乳腺癌组织中的表达较癌旁正常乳腺组织下调(P<0.05);ER阳性组患者中EBP50的表达高于ER阴性组(P<0.05);CerbB-2阳性表达的患者中EBP50表达明显降低(P<0.05);EBP50的表达在病理分期早期的患者中表达高于晚期患者(P<0.05);EBP50在PTEN阳性的组别中表达率高(P<0.05);EBP50阴性的患者术后更容易复发(P<0.05).结论:EBP50 的表达状况可作为评价乳腺癌生物学行为的重要参考指标,有可能成为判断乳腺癌的预后的相关指标.     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。