动态增强磁共振成像在评估女性乳房乳头乳晕血供的应用

目的探究动态增强磁共振成像(DCE-MRI)用于评估女性乳房乳头乳晕血供特点的可行性,为乳房整形手术提供乳头乳晕的血供参考。方法从2012年3月至2019年10月华中科技大学同济医学院附属同济医院影像数据库中收集女性乳腺DCE-MRI图像资料,选择未发现肿物的正常乳房的DCE-MRI图像进行研究。在西门子工作站将患者乳腺DCE-MRI图像通过图像减影获取乳房血管图像,分别对轴位、冠状位和矢状位的最大密度投影(MIP)图像进行评估,结合三维MIP图像识别所有供应乳头乳晕的血管。乳头乳晕的血供被划分为内上、内侧、内下、外上、外侧、外下、中央、上方和下方9个象限,对各个象限血管进行统计和分析,并测量血管至乳房皮肤表面投影的最大距离。采用SPSS 19.0软件进行统计分析,通过卡方检验分别比较左侧与右侧乳房的乳头乳晕复合体(NAC)血供象限分布构成比。计算血管到皮肤距离的平均值、标准差及95%置信区间,通过方差分析比较各象限血管至皮肤距离的差异。P<0.05为差异具有统计学意义。结果共收集到245例患者490只女性乳房DCE-MRI图像,其中97例患者97只乳房发现有乳腺肿物,其余393只为正常乳房(97例单侧乳房、148例双侧乳房),将其作为研究对象。患者年龄23~72岁,平均43.7岁。393只乳房(左侧200只、右侧193只)共发现有637条(左侧311条、右侧326条)乳头乳晕供应血管。在637条血管中,内上象限269条(42.2%),外上180条 (28.3%),内侧57条(8.9%),下方37条(5.8%),中央30条(4.7%),内下25条(3.9%),外下25条(3.9%),上方11条(1.7%),外侧3条(0.5%)。卡方检验表明左侧乳房和右侧乳房在NAC血供象限分布构成比差异无统计学意义(χ2 =6.4,P=0.602)。除中央象限血管以外,所有血管到皮肤表面投影最大距离的平均值为0.91 cm, 95%置信区间为0.86~0.96 cm。方差分析表明各象限供血血管到皮肤投影的最大距离,差异有统计学意义(F=11.4,P<0.001)。结论 DCE-MRI可以清晰地显示乳头乳晕的血供来源。乳头乳晕血供主要来源于内上象限和外上象限的血管,血管在皮下约1 cm深度走行。     

ASO Visual Abstract: Development and Validation of Web-Based Nomograms for Predicting Cause-Specific Mortality in Surgically Resected Nonmetastatic Invasive Breast Cancer: A Population-Based Study

Annals of Surgical Oncology -     

Assessment of Carbendazim Residues and Safety in Celery Under Different Cultivation Conditions

Although the carbendazim is widely used to manage spot blight in celery cultivation, information on residues identified is of interest. In this study, we examined the dissipation and residual amounts of carbendazim in celery and soil under different cultivation methods when using the suggested dose and ten times of that and the bioconcentration factor of carbendazim for celery. The results showed that when celery leaves were sprayed with the suggested dose, the half-lives in a celery field and greenhouse were 2.75 days and 3.29 days, respectively. When the soil matrix was sprayed with the recommended dose before cultivation, the half-lives of carbendazim residues were 16.86 days and 11.97 days. We also conducted a long-term dietary risk assessment using the corresponding criteria. The results showed that, in China, the use of carbendazim at a dose of 0.022 g/m² is safer and more reasonable when the harvest interval is 28 days.

     

A head-to-head comparison of measurement properties of the EQ-5D-3L and EQ-5D-5L in acute myeloid leukemia patients

Quality of Life Research - This study aimed to compare the measurement properties of EQ-5D-3L(3L) and EQ-5D-5L(5L) in patients with acute myeloid leukemia (AML) in China. We consecutively recruited...     

4型腺病毒载体的构建和β－半乳糖苷酶基因的表达

以４型腺病毒疫苗株感染Ａ５４９细胞，提取病毒ＤＮＡ，将ＥｃｏＲＩ消化的Ｄ片段（７０．５－８３．０基因图谱单位）克隆入ｐＵＣ１８质粒，得ｐＡｄ４（７０．５－８３）质粒，质粒ｐＡｄ４（７０．５－８３）和ｐＡｄ４Ｃ１－２５经酶切、系列亚克隆、加接头等方法得到大部分和部分缺失Ｅ３区的重组质粒。聚合酶链反应（ＰＣＲ）法获得ｐｏｌｙ（Ａ），构建约８００ｂＰ腺病毒晚期表达盒，在所构建的腺病毒重组质粒Ｅ３缺失区或Ｅ４与ＩＴＲ间插入表达盒，得到可同时表达２个或２个以上外源基因和保留了Ｅ３区编码分子量为１９３００糖蛋白基因的３种Ａｄ４载体。将ｌａｃＺ基因插入载体表达区，与Ｂｅｌｌ消化的Ａｄ４ＤＮＡＡ片段共转染Ａ５４９细胞，ＯＮＰＧ法检测证实所构建的载体和表达盒功能良好。本项工作对于在国内研究口服活疫苗及开展基因治疗均具有重要意义。     

Endogenous estrogen status, but not genistein supplementation, modulates 7,12-dimethylbenz[a]anthracene-induced mutation in the liver cII gene of transgenic big blue rats

A growing number of studies suggest that isoflavones found in soybeans have estrogenic activity and may safely alleviate the symptoms of menopause. One of these isoflavones, genistein, is commonly used by postmenopausal women as an alternative to hormone replacement therapy. Although sex hormones have been implicated as an important risk factor for the development of hepatocellular carcinoma, there are limited data on the potential effects of the estrogens, including phytoestrogens, on chemical mutagenesis in liver. Because of the association between mutation induction and the carcinogenesis process, we investigated whether endogenous estrogen and supplemental genistein affect 7,12-dimethylbenz[a]anthracene (DMBA)-induced mutagenesis in rat liver. Intact and ovariectomized female Big Blue rats were treated with 80 mg DMBA/kg body weight. Some of the rats also received a supplement of 1,000 ppm genistein. Sixteen weeks after the carcinogen treatment, the rats were sacrificed, their livers were removed, and mutant frequencies (MFs) and types of mutations were determined in the liver cII gene. DMBA significantly increased the MFs in liver for both the intact and ovariectomized rats. While there was no significant difference in MF between the ovariectomized and intact control animals, the mutation induction by DMBA in the ovariectomized groups was significantly higher than that in the intact groups. Dietary genistein did not alter these responses. Molecular analysis of the mutants showed that DMBA induced chemical-specific types of mutations in the liver cII gene. These results suggest that endogenous ovarian hormones have an inhibitory effect on liver mutagenesis by DMBA, whereas dietary genistein does not modulate spontaneous or DMBA-induced mutagenesis in either intact or ovariectomized rats.     

股骨颈骨折不同角度固定的生物力学比较研究

本文通过测量２０个股骨上段标本，Ｘ线片的压力骨小梁系统，按照其骨小梁系统采用低角度固定其股骨颈骨折标本，以临床常用角度固定的股骨颈骨折标本作为对照组，进行静力学测定。股骨上段骨小梁系统与股骨纵轴线所成角度均数为１５４．７±１．９度，骨小梁系统与股骨外侧骨皮质交点到大转子距离均数为７．３±１．０ｃｍ。低角度固定组承载力及最大承载力明显大于对照组（Ｐ＜０．０５），且有更小的旋转移位（Ｐ＜０．０５）。本研究将低角度固定概念量化，对股骨颈骨折内固定的使用有显著的临床指导意义。