吲哚菁绿联合亚甲蓝在乳腺癌前哨淋巴结活检中的临床应用

目的:探讨吲哚菁绿(indocyanine green,ICG)联合亚甲蓝在乳腺癌前哨淋巴结活检(sentinel lymph node biopsy,SLNB)中的临床应用价值。方法:共入组39例乳腺癌患者,在光学分子影像手术导航系统(surgical navigation system,SNS)的引导下,使用ICG联合亚甲蓝实施SLNB。快速冰冻病理证实前哨淋巴结(sentinel lymph node,SLN)转移者,即刻行腋窝淋巴结清扫(axillary lymph node dissection,ALND);SLN阴性者免于ALND。结果:联合法实施SLNB检出率95%,成功检出SLN125个,平均检出3.2个SLN,准确率95.0%,灵敏度100%,假阴性率0%;蓝染法检出率87.2%,成功检出SLN71个,平均检出1.8个SLN,准确率89.7%,灵敏度93.7%,假阴性率为6.3%;统计结果采用x2检验,检验结果具有统计学意义。结论:ICG联合亚甲蓝实施乳腺癌SLNB成功率高,假阴性率低,临床效果不亚于亚甲蓝,是实施SLNB的新方法。     

胃癌前哨淋巴结检测的临床研究

目的:探讨胃癌术中前哨淋巴结(sentinel lymph node,SLN)定位检测的可行性及其临床意义。方法:使用亚甲蓝对40例胃癌患者行前哨淋巴结术中标识活检,随后行D2或D2以上手术。结果:40例胃癌患者中,38例找到前哨淋巴结,检出率为38/40(95%),有32例存在SLN转移,8例SLN为唯一转移部位,且均为T1、T2期。由SLN的病理学状态来预测胃周围淋巴结转移情况的敏感性为32/34(94.12%),特异性为4/4(100%),假阴性率为2/34(5.88%),准确率为34/38(89.47%),其中假阴性的2例,肿瘤都处于T4期。结论:胃癌SLN定位及活检技术能较准确反映早期胃癌的淋巴结转移状况,但对进展期胃癌而言假阴性率较高,对胃癌整个区域淋巴结状态预测的可靠性和可行性尚需进一步验证。     

利用纳米碳与亚甲蓝示踪甲状腺乳头状癌前哨淋巴结的对比研究

目的探讨亚甲蓝和纳米碳混悬注射液细胞染色示踪甲状腺乳头状癌前哨淋巴结(SLN)的价值。方法选择130例甲状腺乳头状癌患者,按不平衡指数最小分配原则随机分为2组,分别用亚甲蓝及纳米碳行SLN活检术,记录SLN的位置及数目,随后行患侧功能性颈淋巴结清扫术,将SLN及清扫的淋巴结分别进行HE染色观察,采用t检验、c2检验、fisher确切概率法对数据进行统计学分析。结果亚甲蓝组65例检出SLN 52例,27例为阳性,其检出率、灵敏度、准确率和假阴性率分别为80.00﹪、84.38﹪、90.38﹪、15.62﹪。纳米碳组65例检出SLN61例,30例为阳性,其检出率、灵敏度、准确率和假阴性率分别为93.84﹪、90.91﹪、95.08﹪、9.09﹪,除检出率相比差异有统计学意义(c~2=5.482,P=0.019),灵敏度、准确率、假阴性率相比差异无统计学意义(fisher确切概率法,P=0.475、0.467、0.475)。两组所检出的SLN在各区的分布情况差异无统计学意义(c~2=1.043、P=0.791),两组均在Ⅳ区和Ⅵ区的检出率、阳性率最高,两组间差异无统计学意义(c~2=1.043,P=0.425;c~2=0.012,P=0.914)。结论纳米碳与亚甲蓝在甲状腺乳头状癌术中细胞示踪SLN均具有可行性,能准确反映颈部淋巴结的状况,对甲状腺乳头状癌淋巴结的清扫具有指导意义,纳米碳较亚甲蓝能获得较清晰的术野,对SLN检出率高,值得推广。     

乳腺导管原位癌行前哨淋巴结活检指征的探讨

目的:分析乳腺导管原位癌的前哨淋巴结临床及病理特征,探讨乳腺导管原位癌患者实施前哨淋巴结活检的指征。方法:回顾性分析2002年10月到2010年11月期间诊断为乳腺导管原位癌并行前哨淋巴结活检的46例患者的的前哨淋巴结状态及其与其他临床及病理特征的关系。结果:患者的年龄、肿瘤大小、检出SLN数、肿瘤分级、切缘状态、DCIS类型、是否伴随坏死均无显著统计学意义(P0.05)。可能与乳腺导管原位癌患者前哨淋巴结阳性的几个因素为:年龄41岁-69岁、肿瘤大小1.1 cm-5.0cm、切缘状态未知、肿瘤坏死伴随或未知、肿瘤分级Ⅰ级以上或未知。结论:以下几个因素可能对预测DCIS患者可能出现SLN阳性提供帮助,临床在遇到出现这些因素的DCIS患者需慎重考虑其治疗策略,这些因素包括:年龄41岁-69岁、肿瘤大小1.1cm-5.0 cm、切缘状态未知、肿瘤坏死伴随或未知、肿瘤分级Ⅰ级以上或未知。     

吲哚菁绿和亚甲蓝在乳腺癌前哨淋巴结活检中的应用对比研究

目的:比较吲哚菁绿和亚甲蓝在乳腺癌前哨淋巴结活检中的临床疗效。方法:选取我院2014年3月至2016年3月期间收治的240例乳腺癌患者,随机分为荧光组(n=120)及染色组(n=120),其中以吲哚菁绿作为示踪剂为荧光组,以亚甲蓝作为示踪剂为染色组,两组患者行前哨淋巴结活检结术后,行I、II水平腋窝淋巴清扫,比较术后两种示踪剂检出率、假阴性率及前哨淋巴结(SLN)检出个数,比较S型与M型淋巴引流的患者比例差异。结果:荧光组前哨淋巴结检出率为99.7%(116/120),染色组为93.3%(112/120),与染色组相比,荧光组检出率提高,组间比较数据具有统计学意义(P0.05),荧光组假阴性率为5.2%,染色组假阴性率为8.4%,两组平均检出前哨淋巴结数量分别为荧光组(4.4±1.5)枚,染色组(4.2±1.6)枚,组间数据无统计学意义(P0.05)。结论:吲哚菁绿检出率高于染料法,更适合作为前哨淋巴结活检术示踪剂。     

胃癌前哨淋巴结检测的临床研究

目的：探讨胃癌术中前哨淋巴结（sentinel lymph node,SLN）定位检测的可行性及其临床意义。方法：44t用亚甲蓝对40例胃癌患者行前哨淋巴结术中标识活检,随后行D2或D2以上手术。结果：40例胃癌患者中,38例找到前哨淋巴结,检出率为38／40（95％）,有32例存在SLN转移,8例SLN为唯一转移部位,且均为T1、T2期。由SLN的病理学状态来预测胃周围淋巴结转移情况的敏感性为32／34（94．12％）,特异性为4／4（100％）,假阴性率为2／34（5．88％）,准确率为34／38（89．47％）,其中假阴性的2例,肿瘤都处于T4期。结论：胃癌SLN定位及活检技术能较准确反映早期胃癌的淋巴结转移状况,但对进展期胃癌而言假阴性率较高,对胃癌整个区域淋巴结状态预测的可靠性和可行性尚需进一步验证。     

早期子宫颈恶性肿瘤腹腔镜手术中两种示踪剂前哨淋巴结活检结果的对比分析

目的:通过在早期子宫颈恶性肿瘤患者中应用吲哚箐绿(ICG)及纳米炭混悬液为示踪剂行腹腔镜下前哨淋巴结(sentinel lymph node,SLN)切除术,对比两种示踪剂的示踪效果,寻找临床更适宜普遍使用的示踪剂。方法:选取仁济医院妇瘤科2016.8～2019.10期间诊断明确的122例早期子宫颈恶性肿瘤患者为研究对象。随机采用ICG或纳米炭为前哨示踪剂。对两种示踪剂的显影情况和SLN的示踪效果进行分析。结果:在122例子宫颈恶性肿瘤病例中,宫颈注射ICG64例,检出SLN385枚,平均每个患者检出6.02枚SLN,检出率100%(64/64),特异度96.77%,敏感度75%。宫颈注射纳米炭混悬液58例,检出SLN265枚,平均每个患者检出4.57枚SLN,检出率96.9%(56/58),特异度96.36%,敏感度66.67%。两种示踪剂都有较好的示踪效果(P=0.9356)。结论:早期子宫颈恶性肿瘤行宫颈注射ICG或纳米炭混悬液,腹腔镜下显影的SLN均具有较高的检出率与准确率,是一种较为可行的方法,可普遍开展,值得推广。     

125I标记的Flt4多抗检测荷瘤小鼠前哨淋巴结的探讨

目的 探讨125I标记的Flt4多抗(125I-Flt4PcAb)对荷瘤小鼠前哨淋巴结(sentinel lymph node,SLN)的检测,为应用Flt4PcAb进行SLN特异性定位提供实验依据.方法 建立BALB/c裸小鼠后肢荷瘤模型,7周后应用125IFh4PcAb检测肿瘤的SLN,健侧作为对照,切取(月园)窝淋巴结探测γ射线的每分钟计数率(count per minute,Cpm),并进行HE及角蛋白免疫组化染色;分析不同状态淋巴结摄取125I-Flt4PcAb的特点.结果 BALB/c裸小鼠后肢皮下注射Tca-8113细胞悬液,移植瘤成功率达100%;患侧70枚(月园)窝淋巴结中,HE染色3枚(4.3%)出现肿瘤转移;角蛋白免疫组化染色为5枚(7.1%);125I-Flt4PcAb摄取方面,肿瘤转移淋巴结、反应性增生淋巴结和正常淋巴结之间均有显著差异(P＜0.05).结论 BAIB/c裸小鼠后肢皮下注射Tca-8113细胞悬液可成功致瘤,但淋巴结转移率低;免疫组化染色较HE染色检测肿瘤转移更敏感;125I-Flt4PcAb能够检测到荷瘤鼠的SLN,肿瘤转移淋巴结对125I-Flt4PcAb的摄取下降.     

~(125)Ⅰ标记的Flt4多抗检测荷瘤小鼠前哨淋巴结的探讨

目的探讨125I标记的Flt4多抗(125I-Flt4PcAb)对荷瘤小鼠前哨淋巴结(sentinel lymph node,SLN)的检测,为应用Flt4PcAb进行SLN特异性定位提供实验依据。方法建立BALB/c裸小鼠后肢荷瘤模型,7周后应用125I-Flt4PcAb检测肿瘤的SLN,健侧作为对照,切取窝淋巴结探测γ射线的每分钟计数率(count per minute,Cpm),并进行HE及角蛋白免疫组化染色;分析不同状态淋巴结摄取125I-Flt4PcAb的特点。结果BALB/c裸小鼠后肢皮下注射Tca-8113细胞悬液,移植瘤成功率达100%;患侧70枚窝淋巴结中,HE染色3枚(4.3%)出现肿瘤转移;角蛋白免疫组化染色为5枚(7.1%);125I-Flt4PcAb摄取方面,肿瘤转移淋巴结、反应性增生淋巴结和正常淋巴结之间均有显著差异(P<0.05)。结论BALB/c裸小鼠后肢皮下注射Tca-8113细胞悬液可成功致瘤,但淋巴结转移率低;免疫组化染色较HE染色检测肿瘤转移更敏感;125I-Flt4PcAb能够检测到荷瘤鼠的SLN,肿瘤转移淋巴结对125I-Flt4PcAb的摄取下降。     

初诊腋窝淋巴结阳性乳腺癌新辅助化疗后对腋窝淋巴结转阴性前哨活检的影响分析

摘要 目的：探究对初诊腋窝淋巴结阳性乳腺癌行新辅助化疗患者开展腋窝前哨淋巴结活检的临床意义。方法：选择2017年1月至2020年10月于我院接受改良根治术或保乳术治疗的100例初诊腋窝淋巴结阳性乳腺癌患者,将其中50例病理检测II B、III期行4~8个疗程新辅助化疗后实施前哨淋巴结活检患者设为研究组,将50例I、II A期直接行前哨淋巴结活检患者设为对照组,对比两组患者前哨淋巴结检出率、准确率、假阴性率和灵敏度,同时就患者病理特征与前哨淋巴结检出率的相关性开展分析。结果：（1）比较显示研究组患者与对照组患者在前哨淋巴结检出数、前哨淋巴结检出率以及前哨淋巴结假阴性率方面组间差异不大（P>0.05）;（2）病理学特征分析显示肿瘤直径以及临床N分期同新辅助化疗后患者前哨淋巴结检出阳性率密切相关（P<0.05）。结论：对初诊腋窝淋巴结阳性行新辅助化疗乳腺癌患者实施前哨淋巴结活检具有较显示的临床意义,能够较好的预测患者腋窝淋巴结状况,同时化疗前肿瘤直径、临床N分期是影响前哨淋巴结检出率的重要影响因素。     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

Enterovirus 71 3C proteolytically processes the histone H3 N-terminal tail during infection

Highlights
1. The N-terminal tail of histone H3 is specifically cleaved during EV71 infection.
2. Viral protease 3C is identified as a protease responsible for proteolytically processing the N-terminal H3 tail.
3. Our finding reveals a new epigenetic regulatory mechanism for Enterovirus 71 in virus-host interactions.     

Detection of EBV and HHV6 in the Brain Tissue of Patients with Rasmussen’s Encephalitis

Rasmussen’s encephalitis (RE) is a rare pediatric neurological disorder, and the exact etiology is not clear. Viral infection may be involved in the pathogenesis of RE, but conflicting results have reported. In this study, we evaluated the expression of both Epstein-Barr virus (EBV) and human herpes virus (HHV) 6 antigens in brain sections from 30 patients with RE and 16 control individuals by immunohistochemistry. In the RE group, EBV and HHV6 antigens were detected in 56.7% (17/30) and 50% (15/30) of individuals, respectively. In contrast, no detectable EBV and HHV6 antigen expression was found in brain tissues of the control group. The co-expression of EBV and HHV6 was detected in 20.0% (6/30) of individuals. In particular, a 4-year-old boy had a typical clinical course, including a medical history of viral encephalitis, intractable epilepsy, and hemispheric atrophy. The co-expression of EBV and HHV6 was detected in neurons and astrocytes in the brain tissue, accompanied by a high frequency of CD8⁺ T cells. Our results suggest that EBV and HHV6 infection and the activation of CD8⁺ T cells are involved in the pathogenesis of RE.     

Perinatal Vertical Transmission of Chikungunya Virus in Ruili,a Town on the Border between China and Myanmar

正Dear Editor,Chikungunya virus (CHIKV), an arbovirus in the family of Togaviridae, genus Alphavirus, is transmitted by the A.aegyptii or A. albopictus mosquito, and causes disease in humans characterized by fever, rash, and arthralgia (Silva and Dermody 2017; Suhrbier 2019). It was first reported in 1953 in Tanzania, and caused only a few outbreaks and sporadic cases in Africa and Asia in last century. However, in the epidemic in 2004, CHIKV acquired mutations that conferred enhanced transmission by the A. albopictus mosquito(Schuffenecker et al. 2006). Since then, it has successively caused outbreaks in Africa, the Indian Ocean, South East Asia, the South America, and Europe (Zeller et al. 2016).     

Development of a Novel Reverse Transcription Loop-Mediated Isothermal Amplification Method for Rapid Detection of SARS-CoV-2

In conclusion, the novel visual RT-LAMP assay is a simple, rapid, and sensitive approach for detection of SARS-CoV-2, and it is ready for application in primary care and community hospitals or health care centers, and even patients' own houses in response to the current SARS-CoV-2 epidemic because the assay does not require sophisticated equipment and skilled personnel. Furthermore, it is also ready to be used in fields for screening samples from wild animals and environments to facilitate the identification of potential intermediate hosts that mediate the cross-species transmission of SARS-CoV-2 from bats to humans.