转移性乳腺癌的化疗策略

乳腺癌是女性最常见的恶性肿瘤之一,其发病率高居女性肿瘤疾病首位,全世界每年约有50万妇女死于乳腺癌。晚期乳腺癌的治疗目标是控制疾病、缓解症状、延长患者生存时间、提高患者生存质量、减少治疗相关毒性。本文介绍了晚期乳腺癌化疗的相关指征、不同化疗方案的选择、后续的维持治疗方案在转移性乳腺癌患者中的应用情况。     

成人全麻患者术后早期少量饮水安全性和可行性分析

目的：探讨成人全麻患者术后早期少量饮水的安全性和可行性。方法将200例麻醉后监测治疗室全麻患者按随机数字表法分为观察组和对照组各100例。观察组患者实施麻醉后监测治疗室常规护理的同时给予早期少量饮水;对照组患者实施麻醉后监测治疗室常规护理。分别评价两组患者口干程度变化、复苏满意度、呕吐误吸发生率和再次饮水人数。结果观察组患者口干评分为(7.51±1.48)分,明显高于对照组口干评分(1.39±1.20)分,差异有统计学意义(t=32.12,P<0.05);观察组发生误吸4例,对照组6例,两组比较差异无统计学意义(χ2=0.42,P>0.05);观察组复苏满意度评分为(92.35±2.64)分,明显高于对照组的(67.94±7.46)分,差异有统计学意义( t=30.85,P<0.05);观察组有再次饮水意愿者96例,对照组为91例,两组比较,差异有统计学意义(χ2=2.06,P>0.05)。结论全麻患者术后早期饮水具有安全性和可行性。     

Quantification and normalization of noise variance with sparsity regularization to enhance diffuse optical tomography

Conventional reconstruction of diffuse optical tomography (DOT) is based on the Tikhonov regularization and the white Gaussian noise assumption. Consequently, the reconstructed DOT images usually have a low spatial resolution. In this work, we have derived a novel quantification method for noise variance based on the linear Rytov approximation of the photon diffusion equation. Specifically, we have implemented this quantification of noise variance to normalize the measurement signals from all source-detector channels along with sparsity regularization to provide high-quality DOT images. Multiple experiments from computer simulations and laboratory phantoms were performed to validate and support the newly developed algorithm. The reconstructed images demonstrate that quantification and normalization of noise variance with sparsity regularization (QNNVSR) is an effective reconstruction approach to greatly enhance the spatial resolution and the shape fidelity for DOT images. Since noise variance can be estimated by our derived expression with relatively limited resources available, this approach is practically useful for many DOT applications.OCIS codes: (170.1610) Clinical applications, (170.6935) Tissue characterization, (170.4580) Optical diagnostics for medicine, (170.6510) Spectroscopy, tissue diagnostics     

Optical-resolution photoacoustic endomicroscopy in vivo

Optical-resolution photoacoustic microscopy (OR-PAM) has become a major experimental tool of photoacoustic tomography, with unique imaging capabilities for various biological applications. However, conventional imaging systems are all table-top embodiments, which preclude their use in internal organs. In this study, by applying the OR-PAM concept to our recently developed endoscopic technique, called photoacoustic endoscopy (PAE), we created an optical-resolution photoacoustic endomicroscopy (OR-PAEM) system, which enables internal organ imaging with a much finer resolution than conventional acoustic-resolution PAE systems. OR-PAEM has potential preclinical and clinical applications using either endogenous or exogenous contrast agents.OCIS codes: (170.0170) Medical optics and biotechnology, (170.3880) Medical and biological imaging, (170.3890) Medical optics instrumentation, (170.5120) Photoacoustic imaging, (170.2150) Endoscopic imaging, (170.0180) Microscopy     

Wide-field fluorescence molecular tomography with compressive sensing based preconditioning

Wide-field optical tomography based on structured light illumination and detection strategies enables efficient tomographic imaging of large tissues at very fast acquisition speeds. However, the optical inverse problem based on such instrumental approach is still ill-conditioned. Herein, we investigate the benefit of employing compressive sensing-based preconditioning to wide-field structured illumination and detection approaches. We assess the performances of Fluorescence Molecular Tomography (FMT) when using such preconditioning methods both in silico and with experimental data. Additionally, we demonstrate that such methodology could be used to select the subset of patterns that provides optimal reconstruction performances. Lastly, we compare preconditioning data collected using a normal base that offers good experimental SNR against that directly acquired with optimal designed base. An experimental phantom study is provided to validate the proposed technique.OCIS codes: (070.6120) Spatial light modulators, (110.4234) Multispectral and hyperspectral imaging, (170.3010) Image reconstruction techniques, (170.6920) Time-resolved imaging, (170.6960) Tomography     

吉西他滨联合顺铂治疗老年晚期非小细胞肺癌的临床疗效

目的评价吉西他滨联合顺铂（GP方案）治疗老年晚期非小细胞肺癌的临床疗效与毒副反应。方法对30例经病理和（或）细胞确诊的老年晚期非小细胞肺癌患者，采用吉西他滨联合顺铂化疗。吉西他滨1000mg／m^2，静脉点滴，第1，8天各静滴1次；顺铂25mgc／m^2，静脉点滴，第1，2，3天各静滴1次，每28d为一个周期，化疗中记录毒副反应。2个周期为1个疗程。疗程结束后，评定疗效与毒副反应。结果全组完全缓解（CR）0例，部分缓解11例（11／30），总有效率36．67％。最常见的毒副反应为白细胞减少和血小板减少。结论吉西他滨联合顺铂方案治疗老年晚期非小细胞肺癌患者临床疗效较好，毒副反应可耐受，值得推广应用。     

The reliability of evaluation of hip muscle strength in rehabilitation robot walking training

[Purpose] The primary purpose of this study was to evaluate the intraclass correlation coefficient in obtaining the torque of the hip muscle strength during a robot-assisted rehabilitation treatment. [Subjects] Twenty-four patients (15 males, 9 females) with spinal cord injury participated in the study. [Methods] The subjects were asked to walk during robot-assisted rehabilitation, and the torque of the muscle strength which was measured at hip joint flexion angles of −15, −10, −5, 0, 5, 10, 15, 20, 25, and 30 degrees. [Results] The intraclass correlation coefficient of the torque of the hip muscle strength measured by the rehabilitation training robot was excellent. [Conclusion] Our results show that measurement of torque can be used as an objective assessment of treatment with RAT.Key words: Hip muscle strength, Robot-assisted rehabilitation     

Kallistatin Ameliorates Influenza Virus Pathogenesis by Inhibition of Kallikrein-Related Peptidase 1-Mediated Cleavage of Viral Hemagglutinin

Proteolytic cleavage of the hemagglutinin (HA) of influenza virus by host trypsin-like proteases is required for viral infectivity. Some serine proteases are capable of cleaving influenza virus HA, whereas some serine protease inhibitors (serpins) inhibit the HA cleavage in various cell types. Kallikrein-related peptidase 1 (KLK1, also known as tissue kallikrein) is a widely distributed serine protease. Kallistatin, a serpin synthesized mainly in the liver and rapidly secreted into the circulation, forms complexes with KLK1 and inhibits its activity. Here, we investigated the roles of KLK1 and kallistatin in influenza virus infection. We show that the levels of KLK1 increased, whereas those of kallistatin decreased, in the lungs of mice during influenza virus infection. KLK1 cleaved H1, H2, and H3 HA molecules and consequently enhanced viral production. In contrast, kallistatin inhibited KLK1-mediated HA cleavage and reduced viral production. Cells transduced with the kallistatin gene secreted kallistatin extracellularly, which rendered them more resistant to influenza virus infection. Furthermore, lentivirus-mediated kallistatin gene delivery protected mice against lethal influenza virus challenge by reducing the viral load, inflammation, and injury in the lung. Taking the data together, we determined that KLK1 and kallistatin contribute to the pathogenesis of influenza virus by affecting the cleavage of the HA peptide and inflammatory responses. This study provides a proof of principle for the potential therapeutic application of kallistatin or other KLK1 inhibitors for influenza. Since proteolytic activation also enhances the infectivity of some other viruses, kallistatin and other kallikrein inhibitors may be explored as antiviral agents against these viruses.