科创中国

Objective Immediate physical exercise has been recommended for patients in the recovery phase to improve survival and quality of life(QOL)and reduce recurrence of disease.The new NCCN Guidelines for Survivorship also highlighted the role of exercise in post-cancer health,encouraging patients to perform light physical activity following treatment.The aim of our study is to effect of Tai Chi Chuan(TCC)on serotonin and cortisol for monitoring stress and QOL in post-treatment breast cancer patients.Methods Totally85 post-treatment breast cancer patients were enrolled in this study to observe the effects of practicing TCC on recovery,as well as stress and happiness which are indicators of QOL of in patients.Peripheral blood was drawn from study subjects to analyze the levels of serotonin,cortisol and high sensitive C-reactive protein(HSCRP)at baseline,and at 3,6 and 12 months of TCC practice.Blood was drawn from healthy subjects only at baseline.A QOL questionnaire was administered to study subjects at three time points throughout the study,and once for healthy controls.The data were processed by analysis of variance of repeated measurement.Results At 3,6 and 12 months time points following regular TCC exercise,WBC,RBC,hemoglobin in blood samples showed a statistically significant difference(F=161.55,172.14,289.73;all P=0.00);the level of serotonin(biomarker for well-being),cortisol(indicator of stress)and HS-CRP(biomarker for inflammation)showed a statistical improvement(F=307.46,182.85,102.23;all P=0.00).After 3,6 and 12 months of regular TCC exercise,according to the results of QOL questionnaire,the indicators including quality of sleep,perceived hunger,fatigue,contentment,stress and social interaction presented a significant difference(F=312.98,222.64,543.90,46.05,28.10,78.92,all P<0.05),while there was no statistical difference in life dissatisfaction(F=56.61,P=0.166)Conclusions TCC physical activity for post-treatment breast cancer patients improved QOL and overall well-being,leading to improved mental,physical and psychological functioning.Regulated levels of serotonin and cortisol mediated by TCC exercises are proved to be vital for continued good health.

目的 评价超声引导下经直肠前列腺穿刺活检术(TUGPB)的安全性及在前列腺癌(PCa)诊断中的应用价值.方法 回顾性分析本组2007年1月至2011年11月共495例接受血清前列腺特异抗原(PSA)的测定、并行经直肠超声引导下TUGPB的患者临床资料.2009年1月前共穿刺176例,活检点数为8点,由前列腺左右叶分别穿刺3点,中叶穿刺2点;2009年1月后共穿刺319例,活检点数为11~13点,分别穿刺前列腺左右叶各3点,左右侧外周带各2点,再于超声检查发现的前列腺内低回声区及中叶穿刺1~3点,油纱布置入直肠内压迫止血10~60min.穿刺前应用抗生素ld,穿刺后应用抗生素3d.结果 总的癌检出率为37.8%( 187/495),其中2009年1月前癌检出率为29.0% (51/176),2009年1月后癌检出率为42.6% (136/319),差异有统计学意义(P<0.05).本组495例患者,腺体中有低回声区者378例,其癌检出率为38.1% (144/378);腺体中无低回声区者117例,其癌检出率为36.8% (43/117);差异无统计学意义(P>0.05).穿刺后患者出现发热8 3例(16.8%),肉眼血尿5 7例(11.5%),排尿困难及尿痛43例(8.7%),血便31例(6.3%),血精19例(3.8%),均经对症治疗后痊愈.结论 超声引导下TUGPB是诊断PCa的一种安全简便的方法,并发症较少且轻微可控;腺体中有无低回声区对PCa的检出率无明显影响差别;活检11~13点可以显著提高阳性率,而并不增加并发症的发生率.

目的 探讨高频彩色多普勒超声对乳腺髓样癌的诊断价值,分析超声误诊原因.方法 回顾性分析经手术病理证实的26例乳腺髓样癌的超声表现,归纳其声像图特征,总结导致误诊的原因.结果 乳腺髓样癌具有特征性声像图表现,包括边界清楚但无包膜、形态尚规则、内部回声低而后方回声增强、血供丰富等.超声诊断符合率81% (21/26),19%(5/26)误诊为纤维腺瘤.结论 高频彩色多普勒超声对乳腺髓样癌诊断符合率较高,分析其误诊原因有利于进一步提高对本病声像图特征的认识,减少误诊.

目的 探讨常规超声按照乳腺影像报告及数据系统(BI-RADS)标准与超声弹性应变率比值法对触诊阴性乳腺肿块的诊断价值.方法 常规超声检查按照BI-RADS-US标准将85例患者91个触诊阴性乳腺病灶进行分级,并于穿刺活检或手术切除前进行超声弹性应变率比值法测定.以病理诊断为金标准,构建受试者应用工作特征曲线( ROC),比较2种不同方法的诊断价值.结果 触诊阴性乳腺恶性病灶弹性应变率比值远大于良性病灶(分别为6.92±5.91和2.49±3.26),两者比较差异显著(P<0.01);弹性应变率比值法与BI RADS-US标准的曲线下面积(AUC)分别为0.891和0.818.两者比较差异无统计学意义(P>0.05);2种方法联合应用构建ROC曲线AUC为0.976,与BI-RADS-US标准比较差异有统计学意义(P<0.01),与弹性应变率比值法比较差异有统计学意义(P<0.05).结论 弹性应变率比值法对触诊阴性乳腺病灶的良恶性评估价值明显;常规超声与超声弹性成像联合应用有助于判断触诊阴性乳腺病灶的良恶性,具有重要的临床应用价值.

背景:Notch信号通路在多种人类恶性肿瘤的发生、发展中起关键作用.研究显示Notch与NF-κB信号通路之间的交互作用可促进胰腺癌进展.目的:明确Notch信号通路对胰腺癌侵袭性的影响及其可能机制.方法:体外培养人胰腺癌细胞株BxPC3,以Notch-1 siRNA下调其Notch-1表达,同时设置转染对照siRNA的阴性对照组和不予siRNA干扰的空白对照组.以Transwell细胞侵袭实验观察各组BxPC3细胞的侵袭能力,电泳迁移率变动分析(EMSA)检测NF-κB活性,蛋白质印迹法检测Notch-1、NF-κB p65、血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)蛋白表达.结果:经Notch-1 siRNA干扰、Notch-1表达下调的BxPC3细胞,Transwell细胞侵袭实验穿膜细胞数较空白对照组和阴性对照组显著减少(26.5±1.3对78.5±2.4和76.7 ±2.2,P<0.01),NF-κB活性显著降低(P<0.01),NF-κB p65、VEGF、MMP-9蛋白表达显著下调(P<0.05).结论:Notch-1可通过激活NF-κB促进其下游基因VEGF、MMP-9表达,由此增强胰腺癌的侵袭性.