ER、PR、HER-2、Ki-67与乳腺癌新辅助化疗疗效相关性分析

目的  探讨雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER-2）、Ki67抗原（Ki-67）与乳腺癌新辅助化疗疗效相关性分析。方法  采用免疫组织化学方法检测81例乳腺癌新辅助化疗前后ER、PR、HER-2、Ki-67的表达情况,并评估其与乳腺癌新辅助化疗有效率的关系。结果  81例患者中临床RR79％,术后pCR（9.9％）,tpCR（6.2％）。达到pCR+tpCR率,（ER阴性）23.0%>（ER阳性）12.7%,（PR阴性）28.6%>（PR阳性）9.4%;ER、PR、HER-2及Ki67等与新辅助化疗疗效之间差异无统计学意义。新辅助化疗前后ER、PR、HER-2的状态改变不明显,差异无统计学意义（P >0.05）,而Ki67的表达数量有统计学意义（P <0.05）,其降低了Ki67的表达水平。结论  乳腺癌新辅助化疗可有效控制肿瘤,ER或PR阴性者较阳性者可获得更高的pCR+tpCR率,Ki67可作为化疗药物敏感性和耐药性的预测指标。

     

乳腺癌新辅助治疗疗效的相关因素探究

目的探究乳腺癌新辅助治疗疗效的相关因素。方法回顾分析我院2012年2月-2012年12月58例接受新辅助治疗的乳腺癌患者,免疫组化法检测患者的雌激素受体（estrogen receptor,ER）、孕激素受体（progesterone receptor,PR）、人表皮生长因子受体（human epidermal growth factor receptor-2,HER-2）表达情况,讨论乳腺癌患者TNM分期、ER、PR、HER-2表达与月经状况、原发肿瘤大小对新辅助治疗疗效的相关性。结果统计显示TNM分期越早,病理完全缓解率愈高,ER阴性、PR阴性、HER-2低表达的患者化疗有效率高,差异有统计学意义（P〈0.05）,而月经状况、原发肿瘤大小对治疗的有效率差异无统计学意义（P〉0.05）。结论 TNM分期越早,ER阴性、PR阴性、HER-2低表达的乳腺癌患者新辅助治疗的疗效更好,病理完全缓解率高。     

乳腺癌分子生物学指标与18F-FDG PET-CT SUVmax的相关性研究

目的比较乳腺癌新辅助化疗18F-FDG正电子发射计算机断层显像（PET-CT）最大标准摄取值（SUVmax）、第一疗程化疗后SUVmax变化率（⊿SUVmax 1%）、第二疗程化疗后SUVmax 变化率（⊿SUVmax 2%）与雌激素受体（ER）、孕激素受体（PR）、表皮生长因子受体-2（HER-2）、Ki-67、p53 表达的关系,探讨乳腺癌新辅助化疗中氟代脱氧葡萄糖（FDG）代谢与乳腺癌分子生物学指标的内在联系。方法完成新辅助化疗前18F-FDGPET-CT 患者211 例,完成第1 次化疗后PET-CT 患者49 例,完成第2 次化疗后PET-CT 患者49 例,测量每次的SUVmax并计算其变化率,在新辅助化疗前取乳腺肿瘤组织进行ER、PR、HER-2、Ki-67及p53免疫组织化学法检查。结果ER 表达阴性组的SUVmax高于ER 表达阳性组（P <0.05）。PR 表达阴性组的SUVmax高于PR 表达阳性组（p <0.05）。PR表达阴性组的⊿SUVmax 2%高于PR表达阳性组（p <0.05）。Ki-67 表达阳性组的SUVmax、⊿SUVmax 2%高于Ki-67 表达阴性组（ p<0.05）。结论ER、PR 阴性患者FDG 代谢要高于ER、PR 表达阳性患者。PR 阴性患者⊿SUVmax 2%高于PR阳性患者,提示PR阴性患者对化疗更敏感。Ki-67 阳性的患者SUVmax高于Ki-67 阴性患者,提示FDG 代谢能一定程度反映乳腺癌的增殖活跃程度。Ki-67 阳性的患者有较高的⊿SUVmax 2%,提示Ki-67 阳性患者对化疗更加敏感。     

三阴性乳腺癌的新辅助化疗疗效分析

目的 探讨乳腺癌雌激素受体(ER)、孕激素受体(PR)及人类表皮生长因子受体2(HER-2)阴性表达对新辅助化疗疗效的影响.方法 对入住笔者所在医院接受新辅助化疗的90例乳腺癌患者在化疗前用免疫组化法检测乳腺癌组织中ER、PR和HER2的表达情况,新辅助化疗3周期结束后进行疗效评价,分析它们之间的相关性.结果 ER(-)/PR(-)/HER-2(-)19例,pCR(病理完全缓解)7例(36.84%);ER(+)/PR(+)/HER-2(+)8例,pCR 1例(12.50%);ER(+)/PR(+)/HER-2(-)28例,pCR 3例(10.71%);ER(-)/PR(-)/HER-2(+)25例,pCR 3例(16%);其他组合中均无pCR.ER(-)/PR(-)/HER-2(-)组合的pCR率与其他组合(非TNBC)比较,差异有统计学意义(P<0.05).结论 三阴性乳腺癌(TNBC)与非TNBC患者相比,新辅助化疗可获得更高的pCR率.     

雄激素受体在乳腺癌新辅助治疗中的表达意义

目的 研究雄激素受体（AR）在接受新辅助治疗（NAT）的乳腺癌中的表达情况,与临床特征及病理特征的相关性,以及影响病理完全缓解（p CR）的相关因素分析,为乳腺癌新辅助治疗提供个体化的治疗依据。方法 收集孝感市中心医院2017年1月1日至2021年12月31日新辅助治疗的乳腺癌患者121例。采用χ2检验（或必要时Fisher确切概率法）,比较AR的表达与临床病理特征之间的关系,以及比较AR的表达与新辅助治疗后临床病理特征的关系,用Logistic回归分析各个变量与pCR的相关性。结果 121例乳腺癌活检标本AR阳性率为70.2%。AR的表达与患者年龄、肿瘤大小、脉管侵犯、淋巴结状态、临床分期无相关性（P>0.05）。AR的表达与雌激素受体（ER）、人类表皮生长因子受体2(Her-2)、病理完全缓解（pCR）、MP分级、分子分型有相关性（P<0.05）;AR的表达与孕激素受体（PR）、细胞增殖核抗原（Ki-67）、组织学分级无相关性（P>0.05）。不同分子分型乳腺癌新辅助治疗后,三阴性乳腺癌中AR的表达与pCR及MP分级有相关性（P<0.05）。多因素分析,AR...     

乳腺癌ER,PR和HER-2的表达状况与新辅助化疗疗效的临床观察

目的探讨乳腺癌组织中ER,PR和HER-2的表达状况与新辅助化疗疗效的关系。方法我院2007-06～2009-07经空芯针活检组织学确诊的乳腺癌患者143例,进行新辅助化疗,均采用TAC方案进行化疗,21d为一个疗程,进行2-4个疗程后观察疗效。结果新辅助化疗总有效率77.6%,临床完全缓解（cCR）31.5%,部分缓解（PR）46.1%,疾病稳定（SD）22.4%,疾病进展（PD）0例,病理完全缓解（pCR）10.5%;单因素分析发现：ER阴性患者的有效率90.0%,ER阳性患者的有效率71.0%,PR阴性患者的有效率88.7%,PR阳性患者的有效率71.1%,ER阴性组与ER阳性组、PR阴性组与PR阳性组化疗有效率差异均有统计学意义（P〈0.05）。HER-2过度表达组有效率75.8%,HER-2非过度表达组有效率78.2%,二者之间差异无统计学意义（P〉0.05）。结论 ER,PR阴性的乳腺癌患者对化疗更敏感,新辅助化疗后获益更多,ER,PR可作为乳腺癌新辅助化疗敏感性的预测指标。     

乳腺癌患者新辅助化疗疗效因素的相关性研究

目的 新辅助化疗是乳腺癌治疗的重要手段之一.文中讨论乳腺癌术前穿刺活检雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人表皮生长因子受体(human epidermal growth factor receptor-2,HER-2)表达与新辅助化疗有效率的相关性.方法 采用免疫组化的方法检测40例接受新辅助化疗的乳腺癌患者ER、PR、HER-2表达情况,并观察化疗效果.结果 40例乳腺癌患者中,ER、PR阴性表达率分别为42.5%和52.5%,HER-2过表达率37.5%.ER阳性组与ER阴性组化疗有效率差异有统计学意义(P<0.05),PR阳性组与PR阴性组化疗有效率差异有统计学意义(P<0.05),而HER-2过度表达组与非过度表达组化疗有效率差异无统计学意义(P>0.05).结论 ER阴性、PR阴性的乳腺癌患者可能对化疗更敏感,有可能是新辅助化疗敏感性的预测指标.     

血清HER-2neu ECD水平与乳腺癌临床特征及组织中HER-2neu表达的相关性

观察乳腺癌患者血清人类表皮生长因子受体-2（HER-2neu）胞外域部分（ECD）水平,探讨其与乳腺癌临床特征及组织中HER-2neu表达的相关性。方法选取2013 年1 月-2015 年12 月浙江省肿瘤医院乳腺癌患者50 例作为乳腺癌组,健康志愿者50例作为对照组。采用化学发光法测定血清HER-2neu ECD水平。采用免疫组织化学法测定乳腺癌组织中HER-2 蛋白的表达。结果乳腺癌组血清HER-2neu ECD 水平高于对照组（ p<0.05）,乳腺癌组血清HER-2neu ECD阳性率高于对照组（ p<0.05）。50 例乳腺癌组织标本中, HER-2neu阳性表达20 例,阳性率为40.0%。乳腺癌患者TNM 分期Ⅲ期、雌激素受体（ER）阴性、孕激素受体（PR）阴性及肿瘤直径≥3 cm患者血清HER-2neu ECD阳性率高于TNM分期Ⅰ、Ⅱ期及ER 阳性、PR 阳性、肿瘤直径<3 cm患者（p <0.05）。20例乳腺癌组织HER-2阳性患者中,9例血清HER-2neu ECD阳性;30 例乳腺癌组织HER-2阴性患者中,29 例血清HER-2neu ECD阴性,两种方法一致性较好（Kappa=0.455,=0.000）。结论乳腺癌患者血清HER-2neu ECD 水平升高、乳腺癌组织中HER-2 蛋白表达的一致性较好、血清HER-2neu ECD水平与TNM 分期、ER、PR及肿瘤大小相关,可作为乳腺癌组织中HER-2 蛋白表达的补充检测方法。     

新辅助化疗与乳腺癌雌、孕激素受体表达的关系研究

目的：探讨新辅助化疗与乳腺癌组织中雌、孕激素受体表达的关系,为乳腺癌治疗的选择及预后提供依据。方法：60例患者采用空心针穿刺活检,病理确诊为乳腺癌,行新辅助化疗,用免疫组织化学方法检测60例乳腺癌患者化疗前后乳腺癌组织中雌激素受体（ER）表达、孕激素受体（PR）的表达情况。结果：新辅助化疗后,60例乳腺癌患者中临床完全缓解（CR）16例（26．67％）,其中病理完全缓解（pCR）4例（6．67％）,部分缓解（PR）36例（60．00%）,稳定（SD）7例（11．67％）,进展（PD）1例（1．67％）,临床有效率（cR＋PR）为86．67％。ER阴性表达组新辅助化疗效果优于ER阳性表达组,化疗有效率差异具有统计学意义（P〈0．05）,新辅助化疗前ER阳性表达率为50．00％（28／56）,化疗后ER阳性表达率为64．29％（36／56）,差异有统计学意义（P〈0．05）。结论：ER阴性表达组新辅助化疗效果优于ER阳性表达组,新辅助化疗能使部分乳腺癌组织中的ER表达发生改变,为乳腺癌的治疗提供了一定的依据。     

男性乳腺癌9例诊治分析

目的：探讨男性乳腺癌患者的临床特点、治疗方式、病理类型及预后.方法：回顾性分析赤峰市医院2002～2012年收治9例男性乳腺癌患者的临床资料,分析其病理类型及术后生存时间.结果：手术方式为8例行乳腺癌改良根治术,1例行乳腺癌标准根治术.术后病理示8例为浸润性导管癌,1例为浸润性小叶癌.9例患者行激素受体等免疫组化结果示雌激素受体ER（＋）8例,ER（-）1例;孕激素受体PR（＋）7例,孕激素受体PR（-）2例;人类表皮生长因子受体HER-2（＋）1例,HER-2（-）8例,腋窝淋巴结转移者5年生存率明显低于无转移者.ER、PR阳性者及HER-2阴性表达者5年生存率明显高于ER、PR阴性及HER-2阳性表达者.结论：男性乳腺癌为临床罕见病例,病理类型以浸润性导管癌为主,ER、PR阳性及HER-2阴性表达患者5年生存率较高.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.