乳腺专用伽马显像中99Tcm-甲氧基异丁基异腈的摄取与乳腺浸润性导管癌患者临床病理特征的关系

目的分析乳腺浸润性导管癌患者的临床病理特征与乳腺专用伽玛显像(BSGI)中⁹⁹Tc^m-甲氧基异丁基异腈(MIBI)摄取之间的关系。 方法回顾性分析2014年3月至2018年3月就诊于威海市立医院行BSGI检查、未接受新辅助治疗及穿刺活组织检查及术前无肿瘤远处转移的浸润性导管癌患者244例的临床资料。分析患者的BSGI数据，计算病灶的放射性计数与正常组织的比值(T/N)，从而评估肿瘤对⁹⁹Tc^m-MIBI的摄取量。T/N为偏态分布数据，用M(P₂₅～P₇₅)表示。用Wilcoxon秩和检验分析患者临床病理特征与T/N之间的关系，用多元线性回归模型分析患者临床病理特征对T/N的影响。 结果全部244例患者BSGI中的T/N范围为1.0～7.5。Wilcoxon秩和检验结果显示T/N与T分期、N分期、组织学分级及Ki67表达有关(Z＝－6.852、5.198、－3.931，P均<0.001；Z＝－3.059, P＝0.002)，而与ER、PR、HER-2、P53、EGFR表达及三阴性乳腺癌无关(Z＝ －0.730、－1.526、－1.137、－1.175、－1.224、－1.556, P均>0.050)。多元线性回归分析表明T分期及N分期是T/N的影响因素(t＝5.100, 95%CI：0.414～0.935, P<0.001；t＝ 2.819, 95%CI：0.118～0.668, P＝0.005)。 结论乳腺浸润性导管癌的T分期和N分期可能影响BSGI中肿瘤对⁹⁹Tc^m-MIBI的摄取，因此，可以通过术前测定BSGI的T/N，对肿瘤的恶性程度进行初步评估。     

Intraductal carcinoma of the prostate: What we know and what we do not know

Intraductal carcinoma of the prostate (IDC-P) is a malignant, clonal proliferation of cells growing within the basement membrane-bound structures of the prostate. IDC-P is usually associated with unfavorable clinicopathologic parameters such as large tumor volume, high-grade Gleason score, extra prostatic extension and seminal vesicle invasion. Majority of laboratory and patient data suggest that IDC-P represents intraductal spread of invasive carcinoma, rather than a precursor lesion. Additionally, relationship of IDC-P and adjacent invasive carcinoma has been investigated in a series of molecular studies. The differential diagnosis of IDC-P from other lesions is critical for patient management. In this article, we summarize current literatures regarding what we know about IDC-P, including its pathological morphology, incidence, differential diagnosis, molecular features and clinical significance. In addition, we propose several issues that we currently do not know about IDC-P. Further research is needed to better understand the biological nature of IDC-P.     

Duplex Ultrasound Findings Before and After Surgery in Children and Adolescents with Renovascular Hypertension

We report our experience with duplex ultrasound in young patients with renal artery stenosis (RAS) or middle aortic syndrome (MAS) before and after surgery (1995 and 2009). Of 36 patients (mean age: 13 ± 7 y), 21 had RAS and 15 had MAS. For patients with RAS, the V_max in the affected artery was 350 ± 111 cm/s before surgery and 145 ± 55 cm/s after surgery. The resistance index was 0.46 ± 0.1 in the post-stenotic kidney and increased to 0.60 ± 0.08 after revascularization. Determination of the flow profile in the iliac artery revealed triphasic flow. In individuals with MAS, V_max in the aorta was 323 ± 98 and the resistance index in both kidneys was low, even in the absence of RAS. The flow profile in the iliac arteries was monophasic before surgery and became triphasic after surgery. Duplex ultrasound is useful for the evaluation of children and young adults both pre- and post-surgery. Duplex ultrasound criteria for RAS in adults appear to be applicable in children and young adults also. The diagnostic evaluation of suspected renal vascular disease should include assessment of the aorta and the flow profile in the iliac arteries, as this could help differentiate between aortic and isolated renal artery stenosis.     

建立年幼儿童哮喘诊断标准及预测工具的探索

与其他年龄段儿童相比,年幼儿童是发生哮喘的高危年龄段.由于临床表现非特异、喘息表型多样、辅助检查难以实施等原因,年幼儿童哮喘的诊断对临床医师而言存在一定困难.近二十年来,国内外对年幼儿童诊断标准及预测工具的探索从未停止,而我国也亟需建立起年幼儿童哮喘的诊断标准.该文综述国内外建立年幼儿童哮喘诊断标准及预测工具的过程,为建立我国新的年幼儿童哮喘诊断标准及预测工具提供参考.     

The changing diagnosis of gestational diabetes mellitus: Does anyone miss out?

Our aim was to identify women diagnosed with gestational diabetes mellitus (GDM) using 1999 WHO diagnostic criteria but who would be now classified as normal glucose tolerance (NGT) using updated criteria. We demonstrate that this category change affected 3.3% women and they have a limited increased risk of adverse outcomes.     

质谱流式细胞技术诊断结肠癌患者抗原CD45的临床价值

目的探讨应用离心力对质谱流式细胞技术对结肠癌患者抗原CD45的诊断价值及对其预后质量的影响。方法选取2011年1月～2012年1月我院收治的结肠癌患者120例,收集结肠癌患者的结肠细胞,将收集的结肠癌细胞进行离心,分为400 g离心组为研究组和140 g离心组为对照组(每组细胞数量相同,且均为1×10~5个)。采用质谱流式细胞技术对两组死亡细胞百分比、抗原CD45表达情况及活细胞中高表达CD45的细胞数量进行检测。结果经过研究分析,研究组抗原CD45表达阳性率、抗原阳性率低于对照组,死亡细胞百分比显著高于对照组(P0.05);离心前两组患者K562杀伤比率、NK细胞、B淋巴细胞、T淋巴细胞对比差异无统计学意义(P0.05),离心后研究组K562杀伤比率、NK细胞、B淋巴细胞、T淋巴细胞显著低于对照组(P0.05)。结论对结肠癌患者在运用质谱流式细胞技术对其抗原CD45的诊断同时应用离心力技术,一方面能够提高诊断价值,另一方面能够改善患者的预后质量,值得在临床上进行推广与使用。     

Dry eye disease: A review of diagnostic approaches and treatments

Dry eye (DE) is a common ocular disease that results in eye discomfort, visual disturbance and substantially affects the quality of life. It has a multifactorial etiology involving tear film instability, increased osmolarity of the tear film and inflammation of the ocular surface with potential damage to the ocular surface. This review discusses the classification, diagnostic approaches and treatments of DE.