腋部副乳腺纤维腺瘤的X线钼靶及超声诊断

副乳腺（Supermumergry）是指正常乳腺以外的乳腺组织,亦称异位乳腺、多乳腺症或多乳畸形,属于先天性发育异常,其中以腋部副乳腺最为常见。副乳腺受内分泌的影响,和正常乳腺组织一样可以发生同样的良恶性肿瘤。副乳腺肿瘤比较少见,且因其部位隐匿,易被误诊误治,作者收集17例腋部副乳腺纤维腺瘤的影像资料进行回顾性分析,旨在加强对其的全面认识。     

超声引导下Mammotome微创旋切系统治疗乳腺纤维腺瘤研究(附20例分析)

目的探讨超声引导下Mammotome微创旋切系统切除乳腺纤维腺瘤的可行性和应用价值。方法对20例38个乳腺纤维腺瘤行超声引导下Mammotome微创旋切术。结果20例38个乳腺纤维腺瘤均被准确、完全切除。结论超声引导下Mammotome微创旋切手术可准确、安全、有效根治乳腺纤维腺瘤。     

乳腺巨大肿瘤21例治疗体会

乳腺巨大肿瘤参照乳腺巨纤维腺瘤诊断标准，乳腺巨纤维腺瘤临床上通常指直径7cm以上的乳腺纤维腺瘤，该病临床少见，现总结我院1995年3月至2005年10月收治的乳腺巨大肿瘤21例，现报告如下。     

青年女性"护乳"记

如今越来越多的人患有乳腺纤维腺瘤,它是一种什么病呢?乳腺纤维腺瘤是最常见的乳腺良性肿瘤,是来源于乳腺小叶内纤维组织和腺上皮的混合性瘤,可发生于青春期后任何年龄段的女性,发病高峰在15~25岁。     

青春期乳腺纤维腺瘤核仁组成区嗜银蛋白颗粒(Ag—NOR)定量探讨

青春期乳腺纤维腺瘤生长速度较快,体积较大,活动较好。细胞增生活跃及可见有核分裂像等,对本病的良恶性问题始终没有确切的结论。多数人认为属良性病变,本实验的主要目的是通过Ag—NOR银染技术,对青春期乳腺纤维腺瘤,与其它乳腺良性病变及乳腺癌的关系进行定量研究。 1 材料与方法:①材料:取一年来外科手术切除之乳腺标本108例,其中乳腺纤维腺瘤20例,     

Mammotome微创旋切术在多发性乳腺纤维腺瘤切除术中的应用

目的探讨超声引导下Mammotome微创旋切系统对乳腺多发纤维腺瘤诊断和治疗的临床应用价值。方法分析超声引导下Mammotome微创旋切治疗43例195个临床诊断乳腺多发纤维腺瘤的疗效,并记录术后病理结果及其随访情况。结果 43例195个乳腺病灶被准确完全切除,切除足够组织用于病理诊断;B超监测195个病灶均被完全切除,全部为良性,其中乳腺纤维腺瘤151个,纤维腺瘤样增生44个;3例出现局部血肿,5例出现乳房皮下淤血,均未行特殊处理。术后3个月时复查,血肿完全自行吸收,皮肤淤血消失。结论 Mammotome微创旋切术是一项创伤小、并发症少、安全有效的乳腺微创技术,对乳腺多发纤维腺瘤能够进行完全切除。     

乳腺多发性纤维腺瘤采用乳腺下缘切口经乳腺后间隙入路术治疗的临床价值探析

目的对应用乳腺下缘切口经乳腺后间隙入路术对患有乳腺多发性纤维腺瘤疾病的患者实施治疗的临床效果进行研究。方法选择在我院就诊的患有乳腺多发性纤维腺瘤疾病的患者84例,随机随机分为对照组和治疗组,平均每组42例。采用传统切口手术方式对对照组患者实施治疗;采用乳腺下缘切口经乳腺后间隙入路术方式对治疗组患者实施治疗。结果治疗组患者乳腺多发性纤维腺瘤疾病的治疗效果明显优于对照组。结论应用乳腺下缘切口经乳腺后间隙入路术对患有乳腺多发性纤维腺瘤疾病的患者实施治疗的临床效果非常明显。     

彩色多普勒超声检查乳腺肿块20例分析

目的：分析乳腺纤维腺瘤与乳腺结构不良症的影像学特征,探讨彩色多普勒超声检查女性乳腺肿块的临床诊断价值。方法回顾性分析20例女性彩色多普勒超声检查资料,部分病例术后病理检查。结果20例患者中,乳腺纤维腺瘤13例（65．0％）,乳腺结构不良症6例（30．0％）,乳腺化生性癌1例（5.0％）。典型的乳腺纤维腺瘤声像学表现形态规则、境界清晰,内回声均质。结论彩色超声检查乳腺病变简便有效无创,值得临床广泛推广。分析乳腺纤维腺瘤的声像图表现,有助于乳腺病的诊断和鉴别诊断,提高诊断水平。     

乳晕边缘小切口切除乳腺纤维腺瘤

目的探讨手术治疗乳腺纤维腺瘤的最佳切口选择。方法回顾性分析5年间采用乳晕小切口治疗乳腺纤维腺瘤148例的临床资料。结果全部患者通过手术切除了乳房纤维腺瘤,对手术切口的选择均表示满意。结论乳晕小切口乳房肿块切除术不仅能切除纤维腺瘤,而且无明显瘢痕。     

乳腺巨大纤维腺瘤的影像诊断及鉴别诊断

乳腺纤维腺瘤又称乳腺纤维瘤,是乳腺最常见的良性肿瘤。其分型除普通腺瘤外,还包括3种特殊的亚型：青春型纤维腺瘤（ FA）、乳腺巨大纤维腺瘤（ GF）及叶状囊性肉瘤,由于GF与FA的组织学相似,因此认为是同一疾病不同年龄阶段的表现,亦有学者将GF看作FA的一种特殊亚型,因此又称作青春型乳腺巨纤维腺瘤［1］。国内外GF的诊断标准略有不同,多数学者认为肿瘤直径﹥5cm或重量﹥500g、病理检查符合纤维腺瘤者均可诊断为巨大乳腺纤维腺瘤［2］;临床比较少见,影像学表现无特异性。多发生于儿童及青春期本组36例,均为女性,年龄19~55岁,病程1~3年,均以乳房肿块就诊,查体患侧乳腺明显大于对侧,肿块较硬,皮肤张力高,乳头溢液4例,腋下触及增大淋巴结6例。36例均行乳腺钼靶X线摄影,为意大利MSM2全乳数字化X线成像系统进行乳腺摄影,常规摄取乳腺头尾位（轴位 CC ）及外斜位（ MLO）位,部分加照侧位。采用自动曝光条件,乳腺加压摄影,获取图像并传至工作站,进行后处理及诊断。     

Prenatal nicotine exposure enhances the susceptibility to metabolic syndrome in adult offspring rats fed high-fat diet via alteration of HPA axis-associated neuroendocrine metabolic programming

Aim： Prenatal nicotine exposure （PNE） alters the hypothalamic-pituitary-adrenocortical （HPA） axis-associated neuroendocrine metabolic programming in intrauterine growth retardation offspring rats. In this study we aimed to clarify the susceptibility to metabolic diseases of PNE offspring rats fed a high-fat diet. Methods： Maternal Wistar rats were injected with nicotine （1.0 mg/kg, sc） twice per day from gestational day 11 until full-term delivery, and all pups were fed a high-fat diet after weaning and exposed to unpredictable chronic stress （UCS） during postnatal weeks 18-20. Blood samples were collected before and after chronic stress, and serum ACTH, corticosterone, glucose, insulin, total cholesterol, triglyceride and free fatty acids levels were measured. The hypothalamus, pituitary gland and liver were dissected for histological studies. Results： UCS significantly increased the serum ACTH, corticosterone and insulin levels as well as the insulin resistant index without changing the serum glucose, total cholesterol, triglyceride and free fatty acids levels in adult offspring rats without PNE. The body weight of PNE offspring rats presented a typical ＂catch-up＂ growth pattern. PNE not only aggravated the UCS-induced changes in the HPA axis programmed alteration （caused further increases in the serum ACTH and corticosterone levels）, but also significantly changed the glucose and lipid metabolism after UCS （caused further increases in the serum glucose level and insulin resistant index, and decrease in the serum free fatty acids）. The effects of PNE on the above indexes after UCS showed gender differences. Pathological studies revealed that PNE led to plenty of lipid droplets in multiple organs. Conclusion： PNE enhances not only the HPA axis, but also the susceptibility to metabolic diseases in adult offspring rats fed a high-fat diet after UCS in a gender-specific manner and enhances the susceptibility to metabolic diseases in adult offspring rats fed a high-fat diet.     

Hsp90 inhibitor BILBO21 enhances triptolide-induced apoptosis of human T-cell acute lymphoblastic leukemia cells in vitro mainly by disrupting p53- MDM2 balance

Aim： To investigate the effects of BILBO21, an inhibitor of heat shock protein 90 （Hsp90） alone or in combination with triptolide （TPL） on T-cell acute lymphoblastic leukemia （T-ALL） and the mechanisms of action. Methods： Human T-ALL cells line Molt-4 was examined. The cell viability was measured using M]-I- assay. Apoptotic cells were studied with Hoechst 33258 staining. Cell apoptosis and cell cycle were analyzed using flow cytometry with Annexin V/PI staining and PI staining, respectively. The levels of multiple proteins, including Akt, p65, CDK4/6, p18, Bcl-2 family proteins, MDM2, and p53, were examined with Western blotting. The level of MDM2 mRNA was determined using RT-PCR. Results： Treatment of Molt-4 cells with BILBO21 （50-800 nmol/L） inhibited the cell growth in a dose-dependent manner （the IC~ovalue was 384.6 and 301.8 nmol/L, respectively, at 48 and 72 h）. BILBO21 dose-dependently induced Go/G1 phase arrest, followed by apoptosis of Molt-4 cells. Furthermore, BILBO21 increased the expression of p18, decreased the expression of CDK4/6, and activated the caspase pathway in Molt-4 cells. Moreover, BILBO21 （50-400 nmol/L） dose-dependently decreased the phospho-MDM2 and total MDM2 protein levels, but slightly increased the phospho-p53 and total p53 protein levels, whereas TPL （5-40 nmol/L） dose- dependently enhanced p53 activation without affecting MDM2 levels. Co-treatment with BILBO21 and TPL showed synergic inhibition on Molt-4 cell growth. The co-treatment disrupted p53-MDM2 balance, thus markedly enhanced p53 activation. In addition, the co-treatment increased the expression of Bak and Bim, followed by increased activation of caspase-9. Conclusion： The combination of BILBO21 and TPL may provide a novel strategy for treating T-ALL by overcoming multiple mechanisms of apoptosis resistance.     

Stereoselective binding of doxazosin enantiomers to plasma proteins from rats,dogs and humans in vitro

Aim： （＋）Doxazosin is a long-lasting inhibitor of a1-adrenoceptors that is widely used to treat benign prostatic hyperplasia and lower urinary tract symptoms. In this study we investigated the stereoselective binding of doxazosin enantiomers to the plasma proteins of rats, dogs and humans in vitro. Methods： Human, dog and rat plasma were prepared. Equilibrium dialysis was used to determine the plasma protein binding of each enantiomer in vitro. Chiral HPLC with fluorescence detection was used to measure the drug concentrations on each side of the dialysis membrane bag. Results： Both the enantiomers were highly bound to the plasma proteins of rats, dogs and humans [（-）doxazosin： 89.4%-94.3%; （＋）doxazosin： 90.9%-95.4%]. （＋）Doxazosin exhibited significantly higher protein binding capacities than （-）doxazosin in all the three species, and the difference in the bound concentration （Cb） between the two enantiomers was enhanced as their concentrations were increased. Although the percentage of the plasma protein binding in the dog plasma was significantly lower than that in the human plasma at 400 and 800 ng/mL, the corrected percentage of plasma protein binding was dog〉human〉rat. Conclusion： （-）Doxazosin and （＋）doxazosin show stereoselective plasma protein binding with a significant species difference among rats, dogs and humans.     

三阴性乳腺癌的生物学特征和治疗策略

三阴性乳腺癌（triple negative breast cancer,T N B C）是指雌激素受体（E R）、孕激素受体（P R）和人表皮生长因子受体2（Her-2）均为阴性的乳腺癌。这类乳腺癌占乳腺癌病理类型的10%-23.8%^[1-5],     

美国与欧洲上市后药品安全风险管理进展概述

近10年来,美国食品药品管理局（FDA）、欧洲药品管理局（EMA）及其他相关单位,对上市后药品安全性监测日益重视,在这一领域取得了显著进展,并且制定了一系列新规定。     

原发性乳腺小细胞癌1例报道

1临床资料患者,女,57岁。2009年12月因左乳肿块在当地医院行乳腺B超考虑乳腺癌可能,行胸、腹部CT未发现明显占位性病变,并在该院行左乳癌改良根治术,术后病理:左侧乳腺小细胞癌,肿块大小4cm×3cm,左腋窝淋巴结,11个系膜淋巴结中有1个癌转移;免     

芳香化酶抑制剂的耐药机制

内分泌治疗耐药其实是一个很古老的话题,从最经典的EBCTCT试验发现,应用他莫西酚（tamoxifen,TAM）5年,乳腺癌的复发率为15%,随访15年中,有33.2%的患者出现复发^[2,3]。     

Sodium hydrosulfide alleviates lung inflammation and cell apoptosis following resuscitated hemorrhagic shock in rats

Aim： To investigate the protective effects of hydrogen sulfide （H2S） against inflammation, oxidative stress and apoptosis in a rat model of resuscitated hemorrhagic shock. Methods： Hemorrhagic shock was induced in adult male SD rats by drawing blood from the femoral artery for 10 min. The mean arterial pressure was maintained at 35-40 mmHg for 1.5 h. After resuscitation the animals were observed for 200 min, and then killed. The lungs were harvested and bronchoalveolar lavage fluid was prepared. The levels of relevant proteins were examined using Western blotting and immunohistochemical analyses. NariS （28 pmol/kg, ip） was injected before the resuscitation. Results： Resuscitated hemorrhagic shock induced lung inflammatory responses and significantly increased the levels of inflammatory cytokines IL-6, TNF-a, and HMGB1 in bronchoalveolar lavage fluid. Furthermore, resuscitated hemorrhagic shock caused marked oxidative stress in lung tissue as shown by significant increases in the production of reactive oxygen species H202 and OH, the translocation of Nrf2, an important regulator of antioxidant expression, into nucleus, and the decrease of thioredoxin I expression. Moreover, resuscitated hemorrhagic shock markedly increased the expression of death receptor Fas and Fas-ligand and the number apoptotic cells in lung tissue, as well as the expression of pro-apoptotic proteins FADD, active-caspase 3, active-caspase 8, Bax, and decreased the expression of Bcl-2. Injection with NariS significantly attenuated these pathophysiological abnormalities induced by the resuscitated hemorrhagic shock. Conclusion： NariS administration protects rat lungs against inflammatory responses induced by resuscitated hemorrhagic shock via suppressing oxidative stress and the Fas/FasL apoptotic signaling pathway.     

人参北芪片的质量控制研究

目的建立人参北芪片的质量标准,控制制剂的质量。方法采用薄层色谱法对制剂中组成药味人参进行鉴别,采用HPLC-蒸发光散射检测法测定制剂中的黄芪甲苷,并进行方法学考察。结果人参的薄层鉴别中,斑点清晰,阴性无干扰。黄芪甲苷在0.9976～14.9640μg与峰面积呈良好的线性关系,平均回收率为98.06%,RSD为1.60%。结论建立的薄层色谱和高效液相色谱定性、定量方法可以用来控制人参北芪片的质量,方法简便可行。