科创中国

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.

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 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 探讨四维超声时空关联成像技术纳入常规胎儿心脏筛查的可行性.方法 应用STIC技术获取的数据库中随机选择30例心脏结构畸形和30例心脏结构正常的胎儿作为研究对象.60例胎儿心脏经产后随访或尸解有54例获得明确诊断结果.后由4组(A、B、C、D组)不同水平的医师在不知道诊断结果的情况下对先前存盘的心脏容积数据做快速离线分析.从事产科超声检查5年及以上者定为具有产前二维超声筛查经验的高水平医师,和5年以下者定为中低水平医师;应用STIC技术1年及以上即定为STIC技术应用经验丰富.A组具有中低水平的产前二维超声筛查经验无STIC技术应用经验,B组具有中低水平产前二维超声筛查经验但有STIC技术应用经验,C组具有高水平产前二维超声筛查经验而无STIC技术应用经验,D组既有高水平产前二维超声筛查经验又有丰富的STIC技术应用经验.结果 A、B、C、D4组正确诊断率分别为:75.00%、77.78%、84.26%、87.04%;A组与B组、C组与D组、A组与C组、B组与D组比较正确诊断率均无明显差别(x2值分别为0.23、0.34、2.85、3.19,P均>0.05);A组与D组比较有差别(x2 =5.09,P<0.05).总正确诊断率为81.02% (350/432).结论 STIC技术易于掌握且对医师的专业经验依赖性小,可以纳入常规胎儿先天性心脏病的筛查中.

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.