肺癌早期诊断的研究进展

大多数肺癌患者在确诊时已属中晚期,5年生存率极低,早期诊断是改善其预后和提高生存率的关键。目前常用的肺癌早期诊断方法包括影像学、内镜和分子生物学技术等。除传统的X线胸片、磁共振（Magnetic Resonance Imaging,MRI）、正电子发射断层显像（Positron Emission Tomography-Computed Tomography,PET-CT）等方法外,近年来逐步应用的高分辨CT（High-ResolutionComputed Tomography,HRCT）、低剂量CT（Low Dose Computed Tomography,LDCT）、自荧光纤维支气管镜（AutomaticFluorescence Bronchoscopy,AFB）、超声支气管内镜（Endo-Bronchial Ultra-Sound,EBUS）、荧光共聚焦显微镜支气管镜（FiberedConfocal Fluorescence Microscopy,FCFM）、细胞内镜（Endocytoscopy,EC）、电磁导航支气管镜（Electromagnetic NavigationBronchoscopy,ENB）、经支气管针吸活检术（Transbronchial Needle Aspiration,TBNA）、呼出气体分析和肿瘤标记物联合检测等,对于肺癌的早期诊断起到了重要作用,明显改善预后。本文就肺癌早期诊断的研究进展进行综述。     

Senescence evasion in melanoma progression: uncoupling of DNA‐damage signaling from p53 activation and p21 expression

The best‐established function of the melanoma‐suppressor p16 is mediation of cell senescence, a permanent arrest following cell proliferation or certain stresses. The importance of p16 in melanoma suggests indolence of the other major senescence pathway through p53. Little or no p53 is expressed in senescent normal human melanocytes, but p16‐deficient melanocytes can undergo p53‐mediated senescence. As p16 expression occurs in nevi but falls with progression toward melanoma, we here investigated whether p53‐dependent senescence occurs at some stage and, if not, what defects were detectable in this pathway, using immunohistochemistry. Phosphorylated checkpoint kinase 2 (CHEK2) can mediate DNA‐damage signaling, and under some conditions senescence, by phosphorylating and activating p53. Remarkably, we detected no prevalent p53‐mediated senescence in any of six classes of lesions. Two separate defects in p53 signaling appeared common: in nevi, lack of p53 phosphorylation by activated CHEK2, and in melanomas, defective p21 upregulation by p53 even when phosphorylated.     

Perfectly registered multiphoton and reflectance confocal video rate imaging of in vivo human skin

We present a multimodal in vivo skin imaging instrument that is capable of simultaneously acquiring multiphoton and reflectance confocal images at up to 27 frames per second with 256 × 256 pixel resolution without the use of exogenous contrast agents. A single femtosecond laser excitation source is used for all channels ensuring perfect image registration between the two‐photon fluorescence (TPF), second harmonic generation (SHG), and reflectance confocal microscopy (RCM) images. Images and videos acquired with the system show that the three imaging channels provide complementary information in in vivo human skin measurements. In the epidermis, cell boundaries are clearly seen in the RCM channel, while cytoplasm is better seen in the TPF imaging channel, whereas in the dermis, SHG and TPF channels show collagen bundles and elastin fibers, respectively. The demonstrated fast imaging speed and multimodal imaging capabilities of this MPM/RCM instrument are essential features for future clinical application of this technique. (© 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Linking predator–prey interactions with exposure to a trophically transmitted parasite using PCR‐based analyses

Parasite transmission is determined by the rate of contact between a susceptible host and an infective stage and susceptibility to infection given an exposure event. Attempts to measure levels of variation in exposure in natural populations can be especially challenging. The level of exposure to a major class of parasites, trophically transmitted parasites, can be estimated by investigating the host's feeding behaviour. Since the parasites rely on the ingestion of infective intermediate hosts for transmission, the potential for exposure to infection is inherently linked to the definitive host's feeding ecology. Here, we combined epidemiological data and molecular analyses (polymerase chain reaction) of the diet of the definitive host, the white‐footed mouse (Peromyscus leucopus), to investigate temporal and individual heterogeneities in exposure to infection. Our results show that the consumption of cricket intermediate hosts accounted for much of the variation in infection; mice that had consumed crickets were four times more likely to become infected than animals that tested negative for cricket DNA. In particular, pregnant female hosts were three times more likely to consume crickets, which corresponded to a threefold increase in infection compared with nonpregnant females. Interestingly, males in breeding condition had a higher rate of infection even though breeding males were just as likely to test positive for cricket consumption as nonbreeding males. These results suggest that while heterogeneity in host diet served as a strong predictor of exposure risk, differential susceptibility to infection may also play a key role, particularly among male hosts. By combining PCR analyses with epidemiological data, we revealed temporal variation in exposure through prey consumption and identified potentially important individual heterogeneities in parasite transmission.     

Risk,parental autonomy and the epistemic divide: preimplantation genetic diagnosis in the Australian print news media, 1990–2007

Preimplantation genetic diagnosis (PGD) is a reproductive/genetic technology which has become the subject of public and scholarly debate because it involves the evaluation and consequent selection (and implantation) or destruction of human embryos. This research investigates the way PGD is constituted in the Australian print news media. Foucauldian discourse analysis reveals that proponents draw on their direct knowledge and experience of PGD to support their claims. There is an epistemic divide between consumers and others claiming direct knowledge, and critics and others drawing on indirect or abstract understandings of PGD. This divide characterizes the discourses present in the data and is directly linked to changes in these over the period under analysis.     

Continuous health monitoring: integrating biomarkers for the management of chronic diseases

With the recent progresses of the information and communication technologies, biosensors and nanotechnologies, the access to continuing health monitoring is becoming real. The development of efficient, accurate and interactive solutions integrating biomarkers for continuing health monitoring might contribute to an improved care of some chronic diseases like hypertension, diabetes or heart failure. Continuing health monitoring might also enhance the efficiency and safety of patient’s treatments.     

Clinical implication of pretreatment neutrophil to lymphocyte ratio in soft tissue sarcoma

Introduction: Elevated neutrophil to lymphocyte ratio has been identified as a prognostic indicator in malignancies whereas; its association with extremity and trunk soft tissue sarcoma remain unclear. The aim of this study is to determine the utility of full blood neutrophil lymphocyte ratio (NLR) in preoperative diagnosis and its predictive value for survival in patients managed for soft tissue sarcoma of the trunk and extremities.

Method: 223 patients who presented with a soft tissue tumor were retrospectively reviewed. The study period was from January 2002–December 2009. Preoperative NLR as well as demographics, clinical and histopathological data were analysed.

Results: Full blood NLR was significantly higher in patient with a soft tissue sarcoma compared to benign soft tissue tumors (p < 0.001). Cox regression analysis demonstrated that elevated NLR >5 (p < 0.05) may be an adverse prognostic factor for Overall Survival.

Conclusion: The preoperative NLR is a simple, investigation predicting the preoperative diagnosis of a soft tissue sarcoma and a predictor of worse overall survival for patient with a soft tissue sarcoma.