Increased plasma cathepsin D concentration in hepatic carcinoma and cirrhosis but not in breast cancer

Using a sandwich enzyme-linked immunoassay, plasma total cathepsin D concentration was assayed in 40 breast cancer patients and 84 patients with various liver diseases and compared to that of 52 normal subjects. There were no significant variations found in breast cancer patients related to tumor size, node invasiveness or metastases. In normal women, cathepsin D levels were slightly but not significantly increased in the luteal phase and in pregnancy. By contrast, plasma cathepsin D concentration was significantly increased in 70-75% of patients with liver disease (cirrhosis, hepatocarcinoma, hepatitis), but not in those with liver steatosis. Cathepsin D was independent of most of the plasma hepatic function tests and was correlated with alpha-fetoprotein in cirrhosis and with alpha-fucosidase in primary hepatocellular carcinoma. We conclude that plasma cathepsin D is not a useful marker in breast cancer. However, since the cellular level of this protease is associated with risk of metastasis in breast cancer, clinical follow-up will be required to test whether high cathepsin D plasma concentration has any prognostic value in liver cirrhosis and primary hepatocarcinoma.     

Investigation of the Effect of Neoadjuvant Chemotherapy on Stage Ⅱ Breast Cancer

OBJECTIVE To investigate the effect of neoadjuvant chemotherapy in treatment of Stage Ⅱ breast cancer. METHODS The data from 113 patients with breast cancer of the same pathologic type in Stage Ⅱ,during the period of 1995 to 2001,were analyzed retrospectively.Among the patients,47 were treated with neoadjuvant chemotherapy,and 66 received no adjuvant therapy before surgery（control group）.After the patients of the neoadjuvant chemotherapy group had received 2 courses of chemotherapy with the CMF regimen,the surgical procedure was conducted. RESULTS Complete remission（CR）was attained in 9 of the 47 cases receiving neoadjuvant chemotherapy and partial remission（PR）was reached for 22 cases.The rate of breast-conserving surgery was enhanced from 22.73%to 46.81%（P〈0.05）in the neoadjuvant treatment group. There was no difference in the 5-year overall survival（OS）and disease-free survival（DFS）rate between the two groups（P〉0.05）,but the 5-year OS and DFS of the cases with clinical tumor remission was higher compared to the control group（P〈0.05）. CONCLUSION Neoadjuvant chemotherapy can enhance the rate of breast conservation for Stage Ⅱ breast cancer and may improve the prognosis of the cases with clinical remission.     

早期DSA检查对蛛网膜下腔出血的临床意义

蛛网膜下腔出血（subarachnoid hemorrhage，SAH）是临床发病率和死亡率均较高的急性脑血管病之一，并呈逐年增高趋势。随着神经介入影像学的发展，对急性SAH患早期（72h内1开展数字减影血管造影（digital subtraction angiography．DSA）检查，使SAH的早期病因诊断及病因治疗成为可能，患的预后也得到显改善。我院自2003年1月至2006年4月收治96例SAH患行早期DSA检查并给予相应的病因治疗．取得较好的临床疗效。现将有关资料与临床治疗总结报道如下。[第一段]     

数字图书馆的个性化信息服务

分析了国内外数字图书馆个性化信息服务的现状及相关技术,提出了建立个性化信息服务系统的方法及个性化信息服务中需要注意的问题.     

健康信念模式在分娩中的应用探讨

目的探讨增强产妇健康信念对产妇分娩方式及产后康复的影响，提高产妇康复质量及产科工作质量。方法将300例产妇随机分为观察组和对照组，对观察组产妇进行分娩相关知识强化培训，增强产妇自然分娩及自我护理信念．对照组只进行一般入院宣教，比较两组剖宫产率、纯母乳喂养、产后24小时自护率等指标。结果观察组产妇剖宫产率明显低于对照组，而纯母乳喂齐、产后24小时自护率等指标均高于对照组。结论增强产妇健康信念，能帮助其自然分娩，降低剖宫产率，提高产妇康复质量。     

穿刺加三苯氧胺治疗乳腺囊肿的疗效观察(附36例)

目的：比较乳腺可扪及囊肿穿刺抽液后服用三苯氧胺和单纯穿刺抽液两种治疗方法的疗效.方法：将临床可扪及乳腺囊肿根据乳腺B超检查结果入组68例,随机分为穿刺抽液治疗组32例和穿刺抽液后服三苯氧胺治疗组36例,两组患者穿刺抽液后中位随访13个月观察疗效.结果：68例可扪及乳腺单纯囊肿,平均囊肿大小23mm,36例穿刺服三苯氧胺组复发率13.89%（5/36）,32例穿刺抽液组复发率37.50%（12/32）,两组相比较（P＜0.05）有显著性差异.乳腺囊肿病史＞1年的患者,穿刺服三苯氧胺组和穿刺组复发率分别是36.36%（4/11）和77.78%（7/9）,两组相比较（P＜0.05）差异有显著性.对单个囊肿,多发囊肿,囊肿病史＜1年患者,两种治疗方法不影响复发率（P＞0.05）.结论：临床可扪及乳腺单纯囊肿可根据B超检查筛选适合穿刺患者,穿刺抽液加服三苯氧胺治疗可减少复发,囊肿病史＞1年者复发率较高.     

Prolonged exclusive breastfeeding is associated with increased atopic dermatitis: a prospective follow-up study of unselected healthy newborns from birth to age 20 years

BACKGROUND: Exclusive breastfeeding for the first 6 months is recommended by the World Health Organization and considered allergy preventive. However, it is not known whether prolonging exclusive breastfeeding for over 6 months provides further benefit in allergy prevention. OBJECTIVE: The aim of this prospective 20-year follow-up study was to find out whether the allergy protective effect can be enhanced by prolonging strictly exclusive breastfeeding for > or =9 months of age. A total of 200 unselected healthy newborns were enrolled in the study. Their mothers were encouraged to maintain exclusive breastfeeding for as long as possible. The number of infants on strictly exclusive breastfeeding was 167 at 2, 116 at 6, 36 at 9 and 7 at 12 months of age. Of the 200 infants, 42% had a family history of allergy. The children were re-assessed at ages 5 (n=163), 11 (n=150) and 20 years (n=164) with clinical examination, skin prick testing, and parental and personal structured interviews. RESULTS: Exclusive breastfeeding prolonged for > or =9 months was associated with atopic dermatitis (P=0.002) and symptoms of food hypersensitivity (P=0.02) at age 5 years, and with symptoms of food hypersensitivity at age 11 years (P=0.01), in children with a family history of allergy. CONCLUSION: Prolonging strictly exclusive breastfeeding for > or =9 months was not helpful in atopy prevention, instead, it was associated with increased atopic dermatitis and food hypersensitivity symptoms in childhood.     

The value of MCA, CA 15-3, CEA and CA-125 for discrimination between metastatic breast cancer and adenocarcinoma of other primary sites

MCA, CA 15-3, CEA and CA 125 were determined in the serum of 49 patients with metastatic breast cancer and 38 patients with metastatic adenocarcinoma of other primary sites. By using the 99th percentile of the normal value distribution as the cut-off point, the positive predictive value (PV+) was found to be 85% (95% CI 76-94) for MCA, and 71% (95% CI 61-81) for CA 15-3. When receiver-operating-characteristic (ROC) curves were constructed, the PV+ for CA 15-3 was increased to 82% (95% CI 72-92), using 60 U ml-1 as the cut-off point. With the exception of two patients who had a slightly elevated MCA, MCA and CA 15-3 identified the same patients with breast cancer. By combining a positive MCA or CA 15-3 with a negative CEA and CA 125, further improvement of the PV+ could be achieved; 100% (95% CI 91-100). We conclude that MCA and CA 15-3 may play a useful role in discrimination between patients with metastatic breast cancer and those with adenocarcinoma of other primary sites.     

Aspiration biopsy cytology of mammary myoepithelioma

A case of ultrastructurally confirmed myoepithelioma of the breast studied by fine-needle aspiration biopsy is reported. Aspirated tumor cells were spindle-shaped with well-defined cytoplasm and oval nuclei showing no remarkable nuclear pleomorphism. They were seen mainly in irregular bundles with strong cellular cohesiveness. Their cytoplasm contained S-100 protein demonstrated by the peroxidase antiperoxidase staining technique.     

BcL-2、Bax、CD44V6在乳腺癌表达及预后的研究

目的探讨影响乳腺癌患者预后的因素,协助临床制定手术方式及术后治疗方案。方法选择80例各型乳腺癌患者的标本,应用免疫组化SP方法,检测乳腺癌组织中癌基因BcL-2、Bax及黏附因子CD44V6的表达情况。结果乳腺癌中BcL-2、Bax及CD44V6的表达情况与肿瘤组织学分级、瘤体直径。有无转移及患者术后存活时间均有显著性相关(P<0.05或0.01)。结论BcL-2高表达、Bax低表达、CD44V6低表达的患者组织学分级好,肿瘤体积小,淋巴结转移少,术后存活时间长,这部分患者可做肿物扩大切除而保留乳房或即使已做乳房切除,术后也可减少放疗及化疗剂量。