Progesterone crosstalks with insulin-like growth factor signaling in breast cancer cells via induction of insulin receptor substrate-2

Both progesterone and the insulin-like growth factors (IGFs) are critically involved in mammary gland development and also in breast cancer progression. However, how the progesterone and IGF signaling pathways interact with each other to regulate breast cancer cell growth remains unresolved. In this study, we investigated progesterone regulation of IGF signaling components in breast cancer cells. We found that insulin receptor substrate-2 (IRS-2) levels were markedly induced by progesterone and the synthetic progestin R5020 in MCF-7 and other progesterone receptor (PR) positive breast cancer cell lines, whereas IRS-1 and the IGF-I receptor were not induced. The antiprogestin RU486 blocked the R5020 effect on IRS-2 expression. Ectopic expression of either PR-A or PR-B in C4-12 breast cancer cells (estrogen receptor and PR negative) showed that progestin upregulation of IRS-2 was mediated specifically by PR-B. The IRS-2 induction by R5020 occurred via an increase of IRS-2 mRNA levels. Furthermore, progestin treatment prior to IGF-I stimulation resulted in higher tyrosine-phosphorylated IRS-2 levels, increased binding of IRS-2 to Grb-2 and the PI3K regulatory subunit p85, and correspondingly enhanced ERK and Akt activation, as compared with IGF-I-only conditions. Taken together, our data suggest that IRS-2 may play an important role in crosstalk between progesterone and the IGFs in breast cancer cells.     

Self-reported memory compensation: similar patterns in Alzheimer's disease and very old adult samples

Evidence pertaining to self-reported use of memory compensation techniques was collected using the Memory Compensation Questionnaire (MCQ). Five forms of everyday memory compensation were evaluated: (a) external memory aids, (b) internal mnemonic strategies, (c) investing and managing processing time, (d) applying more effort, and (e) reliance on human memory aids. The sample was derived from the Kungsholmen Project in Stockholm, Sweden, and consisted of (n = 85) healthy older adults (M age = 81.80 years; M MMSE = 28.34) and (n = 21) diagnosed Alzheimer's Disease (AD) patients (Mage = 81.80 years; M MMSE = 23.55). Participants were tested on two occasions, 6 months apart. Results showed that the MCQ was a largely reliable instrument in these two groups. Moreover, we observed substantial sample similarity in frequency of using the five forms of everyday memory compensation techniques. The healthy sample reported using the external techniques more than the AD sample. Over the 6-month interval, however, AD patients differentially increased their use of others to assist them in everyday memory performance. Results are interpreted in terms of insight into changes in memory skills and inthe implementation of effective memory support systems.     

The protective effect of brachial plexus palsy in purpura fulminans

Acute infectious purpura fulminans is reported in a 16-month-old male with a history of posttraumatic asplenia and complete left brachial plexus palsy. This patient developed peripheral necrosis of both lower extremities and the right upper extremity, whereas the left upper extremity was completely spared from ischemia and tissue damage. Amputation of four digits on the right hand and debridement of both lower extremities were required. This patient demonstrated the protective effect of a traumatic sympathectomy, which suggests the requirement of an intact sympathetic reflex in the development of purpura fulminans.     

Cardiotocography -- proposal of system solution (author's transl)]

A system solution with new technical details and new demands on space distribution is proposed for the use of antenatal cardiotocography and cardiotocographic monitoring of labour. Bedside equipment will be reduced and widely shifted to a centralised control room by introduction of the system. All installations are of high flexibility to leave room for future developments in medical engineering and for necessary services. -- Large-scale use of the new technique with capacity utilisation of the hardware involved will be ensured by appropriate upgrading of labour room personnel as well as by techno-organisational improvement of work and minimisation of expenses on diagnosis and monitoring. The measures proposed work according to expectation and lead to good perinatological results.     

南京医科大学七年制临床医学专业人才培养效果评价

通过对毕业生及其培养或用人单位的问卷调查,本文分析了南京医科大学七年制临床医学专业人才培养的成效,以及江苏省医疗卫生事业发展对高层次医学人才的需求.结果 显示,临床实践能力和科研创新能力是医疗卫生事业发展所需要的高层次医学人才的重要能力;在三级甲等医院工作,具有硕士/博士学位、在专业技术岗位的被调查者更加看重医学生的科研创新能力;而在"1年通识教育、4年医学专业教育(含1年临床课程及见习、1年临床通科实习)、2年二级学科轮转"模式下培养的七年制临床医学专业毕业生的临床实践能力较强,但是科研创新能力不足,且学业负担偏重.因此,应当加强对七年制临床医学专业学生科研创新能力的培养和临床实践能力的通科训练.

Abstract：

An evaluation of 7-year medical education program in Nanjing Medical University was performed via questionnaire survey to the graduates and the staff of hospitals in which the graduates work,and the demand for advanced quality of medical graduates in the field of medical health care in Jiangsu Province is further analyzed. The results showed that the capacity for clinical practice and the capacity for research and innovation are the most important, which can meet the demands of health service development for high-level medical talents. The staff working in advanced hospitals, possessing master or doctor degree,or working as medical experts put more emphasis on the ability of the graduates to do innovative scientific research. Through the completed procedure of the 7-year program includes college general education for 1 year, medical education for 4 years ( containing senior clinical clerkship for 1 year and internship for 1 year) and alternation for medical and surgery subspecialties for 2 years, the graduates showed higher ability to do clinical practice, but not showed the growth of capacity for research and innovation. The most staff investigated proposed an enhancement in training for the capacity for innovative research and general clinical practice.     

Primary Ewing sarcoma: follow-up with Ga-67 scintigraphy

While avid accumulation of gallium-67 citrate and technetium-99m methylene diphosphonate (MDP) occurs initially in most cases of primary Ewing sarcoma, uptake after therapy is less well defined. Thirty patients with Ewing sarcoma who underwent Ga-67 and bone scintigraphy at diagnosis, at completion of therapy, and at relapse from 1978 to 1988 were evaluated. All 30 patients showed less primary site Ga-67 activity following therapy. Twenty-three of 28 patients who underwent corresponding bone scintigraphy showed less uptake, but residual activity was usually more intense than with Ga-67. Avid reaccumulation of Ga-67 occurred in four of five patients with primary site relapse, while patients who underwent bone scintigraphy showed less change. It was concluded that a greater decrease in Ga-67 than in Tc-99m MDP uptake often occurs in patients successfully treated for primary Ewing sarcoma. Information obtained at Ga-67 scintigraphy is most likely to be helpful if results of bone scintigraphy remain abnormal or if occult relapse is suspected.     

紫草剂量与用药时间对药物流产临床效果的影响

本文对药物流产时在不同时间加用不同剂量的紫草对药物流产效果的影响进行探索。紫草的加用时间为米索前列醇 (简称米索 )应用前 3d、后 3d及前后共 6 d,剂量分别为 5 0 g、75 g和 1 0 0 g。 1 35 0例早孕妇女分成 9个研究组进行观察。结果表明 :在米索应用前 3d和前后 6 d加用紫草效果较米索应用后 3d加用紫草在完全流产率和出血时间两方面效果明显改善 (P均 <0 .0 5 )。紫草用量 5 0～ 1 0 0 g时流产效果与紫草剂量无明显相关。因此我们认为药物流产时在应用米索前紫草与米非司酮同时应用效果较好 ,剂量以5 0 g较为合理     

脾切除对结直肠癌切除术后的影响：一项多中心、嵌入式、配对队列研究

目的探讨医源性脾脏损伤脾切除对结直肠癌切除患者术后长期生存的影响。方法对1990年1月1日至1999年12月31日10年间行结直肠癌手术切除并附带脾切除患者进行病例配对回顾研究。分析患者年龄、性别、依据美国麻醉学医师协会（ASA）标准评估的身体状况、疾病分期、手术类型及预后等资料。配对病例来自同一医疗中心，性别、年龄、疾病分期及手术类型完全相同。手术附带脾切除患者为试验组，未切脾者为对照组。结果55例患者行医源性脾切除术，对照组在年龄、性别、身体状况、疾病分期及手术类型上与之匹配。随访时间（从手术开始到患者死亡或者最后一次随访1为2～205个月（中位随访时间为43个月）。Cox比例危险度模型进行Kaplan-Meier法生存分析发现两组间差异有显著性意义，不切除脾脏对患者生存有利（危险度1．8，95％可信区间为1-3．3，P=0．0399），未切脾组与切脾组5年生存率分别为70％和47％，10年生存率分别为55％和38％。结论结直肠癌患者在行结肠或直肠切除时，因医源性脾脏损伤而切除脾脏者，预后较差。