Effect of taxane‐based neoadjuvant chemotherapy on fibroglandular tissue volume and percent breast density in the contralateral normal breast evaluated by 3T MR

The aim of this study was to evaluate the change of breast density in the normal breast of patients receiving neoadjuvant chemotherapy (NAC). Forty‐four breast cancer patients were studied. MRI acquisition was performed before treatment (baseline), and 4 and 12 weeks after treatment. A computer‐algorithm‐based program was used to segment breast tissue and calculate breast volume (BV), fibroglandular tissue volume (FV), and percent density (PD) (the ratio of FV over BV × 100%). The reduction of FV and PD after treatment was compared with baseline using paired t‐tests with a Bonferroni–Holm correction. The association of density reduction with age was analyzed. FV and PD after NAC showed significant decreases compared with the baseline. FV was 110.0 ml (67.2, 189.8) (geometric mean (interquartile range)) at baseline, 104.3 ml (66.6, 164.4) after 4 weeks (p < 0.0001), and 94.7 ml (60.2, 144.4) after 12 weeks (comparison with baseline, p < 0.0001; comparison with 4 weeks, p = 0.016). PD was 11.2% (6.4, 22.4) at baseline, 10.6% (6.6, 20.3) after 4 weeks (p < 0.0001), and 9.7% (6.2, 17.9) after 12 weeks (comparison with baseline, p = 0.0001; comparison with 4 weeks, p = 0.018). Younger patients tended to show a higher density reduction, but overall correlation with age was only moderate (r = 0.28 for FV, p = 0.07, and r = 0.52 for PD, p = 0.0003). Our study showed that breast density measured from MR images acquired at 3T MR can be accurately quantified using a robust computer‐aided algorithm based on non‐parametric non‐uniformity normalization (N3) and an adaptive fuzzy C‐means algorithm. Similar to doxorubicin and cyclophosphamide regimens, the taxane‐based NAC regimen also caused density atrophy in the normal breast and showed reduction in FV and PD. The effect of breast density reduction was age related and duration related. Copyright © 2013 John Wiley & Sons, Ltd.     

Migration capacity of human umbilical cord mesenchymal stem cells towards glioma in vivo*

High-grade glioma is the most common malignant primary brain tumor in adults.The poor prognosis of glioma,combined with a resistance to currently available treatments,necessitates the development of more effective tumor-selective therapies.Stem cell-based therapies are emerging as novel cell-based delivery vehicle for therapeutic agents.In the present study,we successfully isolated human umbilical cord mesenchymal stem cells by explant culture.The human umbilical cord mesenchymal stem cells were adherent to plastic surfaces,expressed specific surface phenotypes of mesenchymal stem cells as demonstrated by flow cytometry,and possessed multi-differentiation potentials in permissive induction media in vitro.Furthermore,human umbilical cord mesenchymal stem cells demonstrated excellent glioma-specific targeting capacity in established rat glioma models after intratumoral injection or contralateral ventricular administration in vivo.The excellent glioma-specific targeting ability and extensive intratumoral distribution of human umbilical cord mesenchymal stem cells indicate that they may serve as a novel cellular vehicle for delivering therapeutic molecules in glioma therapy.     

人参皂苷Rb1在Aβ损伤的PC12细胞中激活线粒体自噬的机制研究＊

目的 基于Aβ损伤的PC12模型，观察人参皂苷Rb1对线粒体自噬的调节作用。方法 用Aβ损伤PC12细胞建立体外AD模型，采用人参皂苷Rb1进行干预后，利用透射电镜观察自噬情况，Western blot检测LC3Ⅱ/Ⅰ、p62、PINK1、parkin、NDP52和OPTN蛋白的表达，荧光实时定量PCR检测LC3、p62、PINK1、parkin、NDP52、OPTN mRNA水平。结果 人参皂苷Rb1高剂量促进细胞中自噬小体包裹受损线粒体，升高LC3Ⅱ/Ⅰ比值（P < 0.05），减少p62蛋白水平（P < 0.05）；同时，人参皂苷Rb1显著增加了PINK1蛋白表达（P < 0.01），同时减少OPTN及NDP52蛋白水平（P < 0.05）；此外，人参皂苷Rb1高剂量组parkin、OPTN mRNA表达显著上调（P < 0.01），低剂量组PINK1、NDP52 mRNA表达也显著上调（P < 0.05）。结论 人参皂苷Rb1神经保护作用与调节线粒体自噬相关，通过激活PINK1/parkin通路促进线粒体自噬而改善体外AD模型损伤情况。     

疏风解毒胶囊联合环丙沙星与维生素C治疗肺风粉刺的临床观察

目的 评价疏风解毒方联合环丙沙星与维生素C治疗肺风粉刺的临床疗效和愈后。方法 将60例痤疮中医辨证为肺经风热型的患者随机分成治疗组与对照组各30例，对照组给予外用盐酸环丙沙星和口服VitC，治疗组在对照组的基础上同时给予疏风解毒胶囊，两组疗程均为1个月。两组分别在治疗2、4周时评价系统症状（口干、便秘等）和皮损炎症好转情况、新发皮损情况、愈后（出现色素沉着和凹陷性瘢痕）情况、临床总有效率，同时考察两组不良反应以评价其安全性。结果 两组治疗后临床疗效对比，治疗组总有效率为96.67%高于对照组的76.67%（P<0.05）。治疗两周后，治疗组口渴、便秘等系统症状减轻例数、皮损处红肿消退例数分别为26例、24例，对照组为4例、7例，治疗组的症状减轻人数明显多于对照组，差异有显著统计学意义（P<0.01）；且两周后治疗组有新发皮损数明显少于对照组，差异有显著统计学意义（P<0.01）。结论 疏风解毒方联合环丙沙星与维生素C在治疗痤疮肺经风热证上疗效显著，愈后理想。     

低剂量瑞芬太尼分娩镇痛联合水中分娩对母婴的影响

目的:探索低剂量瑞芬太尼分娩镇痛联合水中分娩在全程分娩镇痛中的可行性,评价其对产妇和新生儿的影响。方法:选择阴道分娩初产妇160例,ASAⅠ-Ⅱ级,产妇无静脉分娩及水中分娩禁忌证。160例产妇随机分为四组:A组产妇未行镇痛处理,B组单纯静脉自控泵注低剂量瑞芬太尼[0.02μg/(kg·min)],C组静脉自控泵注低剂量瑞芬太尼[0.02μg/(kg·min)]联合水中分娩,D组单纯静脉自控泵注瑞芬太尼[0.04μg/(kg·min)],除C组外,均为自然分娩。观察产妇宫缩时疼痛视觉模拟评分(VAS)、产妇第一产程平均时间、第二产程平均时间、会阴侧切率、剖宫产率以及产后2h出血量。记录分娩镇痛期间产妇的副作用和瑞芬太尼使用总量,记录新生儿娩出后Apgar评分和脐动脉血气分析、新生儿纳洛酮使用情况。结果:与A组比较,C组、D组三组产妇宫缩时VAS均明显降低(P<0.01),C组产妇在宫口开5.0cm至开全时间显著缩短(P<0.05),瑞芬太尼使用总剂量和产后2h平均出血量均显著低于其他三组产妇(P<0.05)。四组新生儿Apgar评分和新生儿脐血气分析差异比较无统计学意义(P>0.05),均在正常范围内。结论:产妇自潜伏期静脉输注低剂量瑞芬太尼[0.02μg/(kg·min)]联合水中分娩可减少瑞芬太尼静脉分娩镇痛药物的总剂量,并使第一产程活跃期时间缩短,减少产后出血和临产产妇的剖宫产率,对新生儿脐血气分析及Apgar评分无影响。     

“临床早期接触”对医学生关怀能力养成的效果分析——以汕头大学医学院“医者之心（HEART）”课程为例

目的探讨医者之心（HEART）课程中“临床早期接触社会实践环节”对关怀能力养成的效果，对该课程纳入“临床早期接触”的教学设计做小结。方法编纂临床早期接触中的“隐性课程”体验问卷，对参加医者之心（HEART）课程的临床早期接触社会实践环节的学生进行事后访问及问卷调查，以此评估“隐形课程”对医学生关怀能力养成的初步情况。 结果医学实习生对各种具有隐性课程内涵举措的各个维度对其关怀能力培育的帮助，均呈偏正向的态度。“带教教师教学示范”“关怀展现”“专业胜任能力对学生关怀能力影响”这3个构面的强弱程度，会因“学生临床早期接触时长”“带教教师年资”“临床早期接触过程满意程度”的不同而呈现显著差异。结论“临床早期接触各类组织形式”对第一次进入临床体验的医学生关怀能力认知有重要影响，典范学习及同伴影响对医学生关怀能力认知有正向影响。     

补体因子H与心血管疾病的研究进展

心血管疾病严重威胁人类健康，具有高发病率、高致死率和高致残率的特点。近年来研究发现，补体因子H（complement factor H，CFH）是补体系统和炎症反应中非常重要的负性调节因子。CFH的减少或缺如可使补体旁路途径持续激活及介导的炎症反应增强，导致血管内皮细胞和心肌细胞等损伤。CFH在心血管疾病的发病中扮演着重要的角色并参与了其病理生理学机制。现系统综述CFH在心血管疾病发病中的作用及机制。     

Melatonin mediates protective effects on inflammatory response induced by interleukin‐1 beta in human mesenchymal stem cells

Joint diseases like osteoarthritis usually are accompanied with inflammatory processes, in which pro‐inflammatory cytokines mediate the generation of intracellular reactive oxygen species (ROS) and compromise survival of subchondral osteoblasts. Melatonin is capable of manipulating bone formation and osteogenic differentiation of mesenchymal stem cells (MSCs). The aim of this work was to investigate the anti‐inflammatory effect of melatonin on MSC proliferation and osteogenic differentiation in the absence or presence of interleukin‐1 beta (IL‐1β), which was used to induce inflammation. Our data showed that melatonin improved cell viability and reduced ROS generation in MSCs in a dose‐dependent manner. When exposed to 10 ng/mL IL‐1β, various concentrations of melatonin resulted in significant reduction of ROS by 34.9% averagely. Luzindole as a melatonin receptor antagonist reversed the anti‐oxidant effect of melatonin in MSCs with co‐exposure to IL‐1β. Real‐time RT‐PCR data suggested that melatonin treatment up‐regulated the expression of CuZnSOD and MnSOD, while down‐regulated the expression of Bax. To investigate the effect of melatonin on osteogenesis, MSCs were cultured in osteogenic differentiation medium supplemented with IL‐1β, melatonin, or luzindole. After exposed to IL‐1β for 21 days, 1 μm melatonin treatment significantly increased the levels of type I collagen, ALP, and osteocalcin, and 100 μm melatonin treatment yielded the highest level of osteopontin. Our study demonstrated that melatonin maintained MSC survival and promoted osteogenic differentiation in inflammatory environment induced by IL‐1β, suggesting melatonin treatment could be a promising method for bone regenerative engineering in future studies.