Migraine is the most common primary headache clinically, with high disability rate and heavy burden. Functional MRI (fMRI) plays a significant role in the study of migraine. This article reviews the main advances of migraine without aura (MwoA) based on resting-state fMRI in recent years, including the exploration of the mechanism of fMRI in the occurrence and development of MwoA in terms of regional functional activities and functional network connections, as well as the research progress of the potential clinical application of fMRI in aiding diagnosis and assessing treatment effect for MwoA. At last, this article summarizes the current distresses and prospects of fMRI research on MwoA.
急性肺损伤( ALI) 及急性呼吸窘迫综合征( ARDS) 是各种肺内外致病因素导致的急性呼吸衰竭, 以进行性呼吸困难和顽固性低氧血症为特征, 常继发于休克、创伤、严重感染以及大面积烧伤等疾病。病理以双肺弥漫性的渗出为特点。病情进展迅速, 预后极差, 具有很高死亡率。治疗时需要纠正缺氧, 以保证组织氧供。传统的常规机械通气( CMV) 在改善氧合、呼吸力学参数以及肺内炎症反应的同时, 导致肺损伤, 即呼吸机相关性肺损伤( VALI) 。近年认为, 采用高频振荡通气( HFOV) 代替CMV 能明显避免产生VALI, 并能改善ALI/ARDS的呼吸系统顺应性和氧合作用, 减轻肺内炎症反应和VALI, 利于急性损伤肺内塌陷和闭塞的小气道和肺泡重新开放。并且有人提出HFOV 与部分液体通气( PLV)联用( HFOV-PLV) 可进一步改善气体交换, 抑制肺组织的炎性反应, 减少肺损伤及氟碳化合物( PFCs) 用量, 稳定全身血液循环, 减少中枢神经系统( CNS) 并发症[ 1] 。
Objective To summarize the research progress of postmenopausal breast cancer and estrogen metabolites, which is aimed at providing the basis for early diagnosis and early treatment of postmenopausal breast cancer, at the same time, providing beneficial information for the future study. Methods In recent years, the literatures about postmenopausal breast cancer and estrogen metabolites were reviewed from the databases of WanFang, VIP, CNKI, PubMed, and so on, to make an review. Results Estrogen metabolites had a dual role for postmenopausal breast cancer, such as 2-hydroxyestrone (2-OHE1), 2-methoxyestrone1 (2-MeOE1), and 4-methoxyestrone1 (4-MeOE1) played a protective role for postmenopausal breast cancer, but 4-hydroxyestrone (4-OHE1) and 16α-hydroxyestrone (16α-OHE1) played a carcinogenic role for postmenopausal breast cancer, so it needed to be further studied. Conclusions Estrogen metabolites may be a reliable predictor for the risk of postmenopausal breast cancer, it is not only to provide clues for the mechanism of postmenopausal breast cancer, but also provide new train of thought for early diagnosis and treatment of postmenopausal breast cancer.
目的 探讨小儿结肠系膜淋巴管瘤的诊断与治疗方法。方法 回顾性分析我院2006年1月至2011年12月期间手术治疗的5例小儿结肠系膜淋巴管瘤的临床资料。结果 3例诊断为腹腔包块性质待查的患儿，术中发现腹腔肿块来源于乙状结肠系膜，其中1例肿块侵犯到降结肠系膜达结肠脾曲而行左半结肠切除＋肠吻合术，另外2例行乙状结肠系膜淋巴管瘤切除＋部分乙状结肠切除＋肠吻合术；1例患儿诊断为急性化脓性阑尾炎合并乙状结肠系膜淋巴管瘤，行阑尾切除＋乙状结肠系膜淋巴管瘤切除＋肠吻合术，1例患儿诊断为乙状结肠系膜淋巴管瘤破裂并弥漫性腹膜炎，行乙状结肠系膜淋巴管瘤切除＋乙状结肠造瘘术，术后6个月后再行二期手术。5例患儿手术后恢复良好，未发生吻合口漏等并发症。术后随访5个月～5年， （2.3±1.1）年，1例失访，余均存活，仍在随访中，所有病例均未复发。结论 日常行阑尾手术中，应常规探查小肠、结肠；未进行肠道准备的结肠一期吻合手术中结肠灌洗可减少吻合口漏等并发症的发生率；腹腔感染严重的患儿结肠一期吻合不可取，结肠造瘘安全；小儿结肠系膜淋巴管瘤术前确诊困难，反复出现腹痛、腹部包块的患儿应想到结肠系膜淋巴管瘤的可能性，行充分的肠道准备后择期手术，手术是肠系膜淋巴管瘤唯一的治疗方法。
ObjectiveTo detect protein expression of androgen receptor (AR) in patients with estrogen receptor (ER)-positive primary breast cancer and investigate its significances on prognosis.MethodsThe clinicopathologic data of female patients with ER-positive primary breast cancer in the Affiliated Hospital of Southwest Medical University from January 2012 to December 2012 were retrospectively analyzed. The AR protein expression in the breast cancer tissue was detected by the immunohistochemistry. The relationship between the AR protein expression and the clinicopathologic characteristics such as the age, tumor diameter, invasive biological behavior, molecular typing or the survival after the operation was analyzed.ResultsThe positive rate of AR protein expression was 58.5% (76/130) in the patients with ER-positive primary breast cancer. The positive rates of AR protein expression in the patients with the low differentiation, clinical stage Ⅲ+Ⅳ, p53 positive, neurovascular invasion, and lymph node metastasis were significantly lower than those in the patients with the moderate and high differentiations, clinical stage Ⅰ +Ⅱ, p53 negative, without neurovascular invasion, and without lymph node metastasis (P<0.050). The positive rate of AR protein expression was not correlated with the age, menstrual status, tumor diameter, progesterone receptor and Her-2 statuses, Ki-67, or molecular typing (P>0.050). The 3-year and 5-year overall survival and tumor-free survival of the AR-positive patients were significantly higher than those of the AR-negative patients (P<0.050). The 5-year cumulative total survival and tumor-free survival of the AR-positive patients were significantly better than those of the AR-negative patients (χ2=8.134, P=0.004; χ2=9.150, P=0.002).ConclusionsPatient with AR protein positive expression in ER-positive breast cancer has a better differentiation, lower clinical stage, and weaker invasiveness. Long-term survival of patient with AR protein positive expression after standardized treatment is also better than that of patient with AR protein negative expression. It might provide an important additional information on prognosis and become a promising object for targeted therapy.