超声造影检查在乳腺BI-RADS 4类的乳腺肿块良恶性鉴别诊断中的价值

目的:探讨超声造影检查在常规超声诊断为乳腺BI-RADS 4类的乳腺肿块良恶性鉴别诊断中的价值。方法:对2016年7月至2017年10月在西安交通大学第一附属医院门诊就诊并经常规超声诊断为乳腺BI-RADS 4类的76例患者共76个乳腺肿块进行超声造影检查,以穿刺活检或手术切除病理结果为金标准建立诊断试验分析。结果:最终病理证实良性病变53例（良性组）,恶性病变23例（恶性组）。超声造影特点如形态不规则、边界不清晰、有穿入或扭曲血管、对比剂不均匀性增强、内部有充盈缺损及造影后面积较二维增大在恶性组的比例显著高于良性组,差异有统计学意义（P<0.05）。超声造影诊断乳腺BI-RADS 4类病灶良恶性鉴别诊断的敏感度、特异度及准确性分别为96%、85%和88%。结论:良恶性乳腺肿块的超声造影特征明显不同,超声造影可以有效鉴别BI-RADS 4类乳腺病灶的良恶性,有望提高穿刺活检的恶性检出率。     

Barriers to accessing palliative care for pediatric patients with cancer: A review of the literature

Although many of the 16,000 children in the United States diagnosed who are with cancer each year could benefit from pediatric palliative care, these services remain underused. Evidence regarding the barriers impeding access to comprehensive palliative care is dispersed in the literature, and evidence specific to pediatric oncology remains particularly sparse. The purpose of the current review was to synthesize the existing literature regarding these barriers and the strategies offered to address them. The authors completed a literature search using the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science databases. In total, 71 articles were reviewed. Barriers to accessing pediatric palliative care were categorized according to the 4 levels of a modified socioecological model (ie, barriers related to policy/payment, health systems, organizations, and individuals). Major themes identified at each level included: 1) the lack of consistent and adequate funding mechanisms at the policy/payment level, 2) the lack of pediatric palliative care programs and workforce at the health systems level, 3) difficulties integrating palliative care into existing pediatric oncology care models at the organizational level, and 4) the lack of knowledge about pediatric palliative care, discomfort with talking about death, and cultural differences between providers and patients and their families at the individual level. Recommendations to address each of the barriers identified in the literature are included. Cancer 2018;124:2278‐88 . © 2018 American Cancer Society.     

Sand flies in Timóteo, Minas Gerais, Brazil

Sporadic cases of tegumentary leishmaniasis have occurred in Timóteo, Minas Gerais State, basically among the rural population. In order to study the region's sand fly population, New Jersey light traps were set in seven different neighborhoods. Specimens were gathered from June through October 1994, December 1994, and January through March 1995, with a total of 3,240 hours per trap. A total of 4,396 sand flies were captured, distributed among two genera and twenty species: Brumptomyia cunhai, Brumptomyia nitzulescui, Lutzomyia (Nyssomyia) whitmani, Lutzomyia (Nyssomyia) intermedia, Lutzomyia quinquefer, Lutzomyia lenti, Lutzomyia (Pintomyia) fischeri, Lutzomyia migonei, Lutzomyia sallesi, Lutzomyia termitophila, Lutzomyia aragaoi, Lutzomyia borgmeieri, Lutzomyia (Psathyromyia) lutziana, Lutzomyia (Sciopemyia) sordellii, Lutzomyia (Pintomyia) pessoai, Lutzomyia (Trichopygomyia) longispina, Lutzomyia misionensis, Lutzomyia (Psychodopygus) davisi, Lutzomyia lanei, Lutzomyia (Pressatia) sp. The species L. (N.) whitmani was the most frequent, with 52.12% of the total, followed by L. (N.) intermedia with 34.10%, and both may be involved in transmission of tegumentary leishmaniasis in the region.     

The inhibitory effects of Radix Astragali on hypoxic pulmonary hypertension of rats

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神经节苷脂GM1对阿尔采默病β-淀粉样蛋白前体代谢的影响

目的研究外源性神经节苷脂ＧＭ１干扰细胞β－淀粉样蛋白前体代谢的作用,探讨ＧＭ１与阿尔采默病特征性病理变化老年斑和其他淀粉样病变形成的关系。方法选用人类β－淀粉样蛋白前体基因（ＡＰＰ６９５）转染细胞模型,用同位素代谢标记方法测定ＧＭ１对细胞β－淀粉样蛋白前体代谢及其水解产物分泌性β－淀粉样蛋白前体释放的影响;用Ｗｅｓｔｅｒｎ印迹和斑点印迹法分析ＧＭ１与重组β－淀粉样蛋白前体的亲和性。结果ＧＭ１干扰细胞β－淀粉样蛋白前体的水解代谢和抑制分泌性β－淀粉样蛋白前体的释放,ＧＭ１与β－淀粉样蛋白前体特异性结合。结论ＧＭ１代谢异常可能与阿尔采默病脑淀粉样蛋白聚积和沉淀有关。     

Expression of nm23 gene in hepatocellular carcinoma tissue and its relation with metastasis

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