目的:探讨早期乳腺癌高频钼靶X线的征象。方法:采用高频钼靶常规乳腺摄影,对经手术及病理证实的25例早期乳腺癌的X线表现资料进行回顾性分析。结果:其中导管原位癌及导管原位伴早浸14例,浸润性导管癌8例,小叶原位癌及小叶癌早浸3例。其X线影像表现为:单纯簇状钙化者8例占32% (8/25),单纯结节5例占20%(5/25),星芒征5例占20% (5/25),结节合并钙化4例占16% (4/25),团片状密度增高影3例12% (3/25)。结论:高频钼靶可以清晰地显示早期乳腺癌的病变结构,是诊断早期乳腺癌首选而有效的方法。
曲霉在自然界中广泛分布，约20种曲霉能感染人类和动物，其中最常见的有烟曲霉、黄曲霉、土曲霉和黑曲霉等。曲霉孢子在空气中传播，人吸入后曲霉可以在气道内定植、致敏、感染，当人体免疫功能低下时可产生危及生命的侵袭性肺曲霉病（IPA）。近年来IPA发病率呈上升趋势，已成为仅次于念珠菌病的主要肺部真菌感染性疾病[1]。虽然IPA已成为器官移植受者、恶性血液病和恶性肿瘤患者等高危人群的重要死因，但对其发病机制了解甚少。本文着重论述近年来IPA发病机制的研究进展。
现已认识到免疫反应、转录因子核因子κB( NF-κB) 的激活、细胞因子、中性粒细胞的激活和肺泡渗入、凝血级联反应、肾素-血管紧张素系统等多种因素构成的复杂网络参与急性肺损伤/急性呼吸窘迫综合征( ALI/ARDS) 的发病过程[ 1-5] 。虽然脓毒症、创伤、肺炎等ALI/ARDS诱发因素很常见, 但仅有部分病人发生ALI/ARDS, 并且具有相似临床特征的ALI/ARDS病人可有截然不同的结果, 这种异质性引起研究者对影响ALI/ARDS 易感性和预后的遗传因子进行鉴别的浓厚兴趣[ 6] 。由于数量庞大的表现型变异, 不完全的基因外显率、复杂的基因-环境相互作用及高度可能的基因座不均一性而使ALI 遗传学的研究受到挑战[ 7] 。近年来基因组学技术被应用于ALI/ARDS 发病机制的研究, 加深了人们对ALI/ARDS的认识并有可能发展出新的治疗策略以降低其发病率和病死率。
Cough variant asthma is a special type of asthma, of which the only or main symptom is cough, and it is the main cause of chronic cough. Early diagnosis and treatment can prevent cough variant asthma developing into typical asthma. This article summarizes the progress in pathogenesis, diagnosis and assessment, treatment, and prognosis of cough variant asthma, aiming to improve the prevention and treatment of this disease, and increase the patients’ quality of life.
Objective To investigate the effects of TiotropiumBromide on airway inflammation in a rat model of chronic obstructive pulmonary disease( COPD) . Methods Thirty Wistar rats were randomly divided into three groups. Group A received normal breeding as normal control. Group B and group C received LPS( 200 μg, intratracheally injected at the 1st and the 14th day) and tobacco exposure( from the 2nd day to the 30th day except the 14th day) to establish COPD model. And group C received a nebulized dose of Tiotropium Bromide( 0. 12 mmol / L, 10 minutes) 30 minutes before the tobacco exposure each time. Airway resistance and compliance were measured before sacrificed. Histological examination was performed with Hematoxylin-Eosin staining. The concentrations of IL-8 and LTB4 , total and differential cells counts in bronchoalveolar lavage fluid( BALF) were examined, and the concentrations of IL-8 and LTB4 in blood serum were also examined by ELISA. Results Severe lung inflammation and decreased lung function were demonstrated in the rats in the group B compared with those in the group A. The inflammatory cell counts in BALF, and the levels of IL-8 and LTB4 in BALF and serum were significantly increased in the group B compared with those in the group A. Tiotropium Bromide administration improved the parameters above. Conclusions The results suggest that Tiotropium Bromide can alleviate the lung inflammation and improve the lung function in a rat COPD model. These effects may be exerted through reducing the mediators of inflammation.
Objective To investigate the blood clotting dysfunction of invasive pulmonary aspergillosis(IPA)and the therapeutic effect of low molecular hepafin in a mouse model．Methods The neutropenic IPA mouse model was constructed by being given cyclophosphamide to depress immunologic function，and then intranasally challenged with Aspergillus fumigatus conidia．(1)Blood clotting function were assessed by bleeding time，clotting time，platelet count and antithrombase-III(AT-III)activity．Seventy-two mice were randomly assigned into 4 groups．Group A received only normal saline．group B received normal saline to substitute the cycloph0sphamide，and the rest equal to group D．Group C received normal saline to substitute the AspergiUus fumigatus conidia suspension，and the rest equal to group D．Group D(model group)received cyclophosphamide(intraperitoneally，150 mg／kg，d4，d1)and Aspergillus fumigatus conidia suspension(intranasally，40 μL／mouse，1．5×10∧5／mL，d0)．Six mice were randomly sacrificed in each group for analysis of blood clotting function per 24 h after inoculation for 3 times．(2)Therapeutic effect of low molecular heparin was determined by survival time of IPA mice．One hundred and eighteen mice were randomly assigned into 4 groups after challenged with 6×10 conidia／mouse and received one of the following regimens daily from dl to d7 after challenge，vehicle(group E，n=29)，low molecular heparin(group F，n=30，subcutaneous injection，1000 IU／kg，qd×7 d)，amphotericin B(group G，n=29，intraperitoneal，1 m kg，qd×7 d)，low molecular heparin plus amphotericin B(group H，n=30)．Mice survivals were recorded once daily to d21 after innoculation．Results (1)AT-III activity of group D decreased significantly 24 h after innoculation．Bleeding time and clotting time decreased significantly and AT—III activity decreased sequentially 48 h after innoculation．The platelet decreased significantly 72 h after innoculation，and bleeding time shoaened further．Clotting time was longer than that 0f 48 h．but still shorter than norm al and AT-III activity decreased sequentially．There were significant differences when comparing group D with group A，B and C(all Plt;0.01)．And there was no significant difference between group A，B and C(all Pgt;0．05)．(2)Survival analysis indicated that the therapeutic effect of low molecular hepafin plus amphotericin B was better than that of amphotericin B or low molecular heparin alone．No therapeutic effect was found in group F(group E vs group F，Pgt;0．05，both group E and group F compared with group H，P lt;0．01．Group H vs group G，P lt;0．05．Both group E and group F compared with group G，P lt;0．05)．Conclusions The results suggest that there is blood clotting dysfunction in IPA mice and AT—III activity may be an early index to monitor the disfunction．Compared with the therapeutic effect of amphoterinein B alone，low molecular hepafin plus amphoterincin B can prolong survival of neutropenic IPA mice
Trans-radial access (TRA) has been a common approach to percutaneous coronary intervention (PCI). Comparing with trans-femoral access (TFA), TRA is used as an alternative approach for PCI with less local complications, higher comfort level, and better outcome. In recent years, TRA has been paid more and more attention in peripheral vascular interventions. We reviewed recent developments in peripheral vascular intervention using TRA, with detail summary of the effectiveness, safety, limits, and future developments of it, aiming to improve the understanding and performance of TRA in interventionalists to benefit patients.
【Abstract】ObjectiveTo study the expressions of P-gp, nm23 and p53 in primary breast cancer tissues and to evaluate the prediction significance in recurrence of the primary breast cancer. MethodsExpressions of P-gp, nm23 and p53 in 57 benign and malignant breast paraffin-embedded specimens, the difference of the rate and intensity of positive reaction of P-gp,nm23 and p53 were checked by immunohistochemical staining.ResultsThe positive rate of nm23 significantly increased in benign breast tissues compared with the tissues of recurrence of breast cancer. The positive intensity of nm23 was significantly decreased in the tissues of recurrence of breast cancer compared with the tissues of primary breast cancer. The positive rate of p53 was significantly increased in malignant breast tissues compared with benign breast tissues. The positive intensity of p53 was significantly increased in the tissues of recurrence of breast cancer compared with the tissues of primary breast cancer. There was no difference in the positive rate of P-gp in the tissue of recurrence and primary of breast cancer compared with benign breast tumor. But the positive intensity of P-gp was significantly decreased in the tissues of recurrence and primary of breast cancer compared with benign breast tumor. ConclusionThe expression of p53 may indicate the proliferating activity of carcinoma cell. The positive intensity of expression of p53 and nm23 is valuable in prediction of the recurrence of primary breast cancer.
Objective To evaluate the biomechanical stability of a newly-designed Y type pedicle screw (YPS) in osteoporotic synthetic bone. Methods The osteoporotic synthetic bone were randomly divided into 3 groups (n=20). A pilot hole, 3.0 mm in diameter and 30.0 mm in deep, was prepared in these bones with the same method. The YPS, expansive pedicle screw (EPS), and bone cement-injectable cannulated pedicle screw (CICPS) were inserted into these synthetic bone through the pilot hole prepared. X-ray film examination was performed after 12 hours; the biomechanical stability of YPS, EPS, and CICPS groups was tested by the universal testing machine (E10000). The test items included the maximum axial pullout force, the maximum running torque, and the maximum periodical anti-bending. Results X-ray examination showed that in YPS group, the main screw and the core pin were wrapped around the polyurethane material, the core pin was formed from the lower 1/3 of the main screw and formed an angle of 15° with the main screw, and the lowest point of the inserted middle core pin was positioned at the same level with the main screw; in EPS group, the tip of EPS expanded markedly and formed a claw-like structure; in CICPS group, the bone cement was mainly distributed in the front of the screw and was dispersed in the trabecular bone to form a stable screw-bone cement-trabecular complex. The maximum axial pullout force of YPS, EPS, and CICPS groups was (98.43±8.26), (77.41±11.41), and (186.43±23.23) N, respectively; the maximum running torque was (1.42±0.33), (0.96±0.37), and (2.27±0.39) N/m, respectively; and the maximum periodical anti-bending was (67.49±3.02), (66.03±2.88), and (143.48±4.73) N, respectively. The above indexes in CICPS group were significantly higher than those in YPS group and EPS group (P<0.05); the maximum axial pullout force and the maximum running torque in YPS group were significantly higher than those in EPS group (P<0.05), but there was no significant difference in the maximum periodical anti-bending between YPS group and EPS group (P>0.05). Conclusion Compared with EPS, YPS can effectively enhance the maximum axial pullout force and maximum rotation force in the module, which provides a new idea for the design of screws and the choice of different fixation methods under the condition of osteoporosis.
Objective To investigate the clinical application of relaying lateral gastrocnemius artery perforator flap in reconstruction of the donor defect after distally sural flap transferring. Methods Between January 2014 and January 2016, 12 cases with foot and ankle defects were treated. There were 10 males and 2 females with an average age of 23.4 years (mean, 14-52 years). The injury was caused by motorcycle accident in 7 cases and traffic accident in 5 cases. The injury located at left limb in 7 cases and right limb in 5 cases. The size of soft tissue ranged from 10 cm×4 cm to 12 cm×6 cm. The disease duration was 2-84 hours (mean, 26.2 hours). The foot and ankle defects were reconstructed by distally sural flaps, then the flap donor sites were reconstructed with relaying lateral gastrocnemius artery perforator flap at the same stage. The size of distally sural flap ranged from 11 cm×5 cm to 13 cm×7 cm. The size of relaying flap ranged from 7 cm×4 cm to 10 cm×6 cm. Results All flaps survived uneventfully. All recipient sites and donor sites healed smoothly. No vascular crisis, wound dehiscence, or evident swelling occurred. All patients were followed up 6-14 months (mean, 12.4 months) with satisfied esthetic and functional results in recipient and donor sites. There were only linear scar on the donor sites. The color and contour was satisfying, the function of calf and foot were not affected. Conclusion The relaying lateral gastrocnemius artery perforator flap combined with distally sural flap is an idea choice to reconstruct foot and ankle defect, which can avoid donor site skin grafting, minimize donor site morbidity.