BI-RADS 3级对乳腺病灶患者的诊断结果及影响因素分析

目的:回顾性分析超声BI-RADS 3级对乳腺病灶患者的诊断结果及影响因素。方法:选择2014年8月至2017年8月上海交通大学医学院附属第九人民医院和复旦大学附属华山医院北院收治的168例乳腺病灶患者,回顾性分析其影像学资料及病理分析结果。分析BI-RADS 3级对乳腺病灶的阴性诊断率,采用Kim分级对BI-RADS 3级结果进行重新分级,分析影响BI-RADS分级及重新分级的主要因素。结果:168例BI-RADS 3级乳腺病灶中,159例为良性病变,9例为恶性。168例BI-RADS 3级乳腺病灶的阳性预测值为5.4%(9/168),阴性预测值为94.6%(159/168)。病灶数目、年龄、医师年资、病灶大小对BI-RADS 3级良恶性乳腺病灶判断无明显影响,而BI-RADS 3级恶性乳腺病灶较良性病灶更易触诊(P 0.05)。重新分级发现,124例仍为BI-RADS 3级,44例上升至BI-RADS 4级,重新分级恶性病灶的检出率为100%(9/9),假阳性率为20.8%(35/168)。病灶多发、年龄≥40岁更可能评估为BI-RADS 4级(P0.05),医师年资、病灶大小、病灶触及情况对重新分级无明显影响(P0.05)。结论:BI-RADS 3级对乳腺良性病灶有较高的阴性诊断率,重新分级可提高乳腺恶性病灶的检出率,但会造成较高的假阳性率,影响BI-RADS分级的主要因素为病灶可否扪及,影响重新分级的主要因素为患者年龄及乳腺病灶是否多发。     

Button osteoma: its etiology and pathophysiology

The present study investigates a circumscribed bony overgrowth on the cranial vault, known as button osteoma (BtO) and referred to here as button lesion (BtL). We discuss its anthropological implications. Data on its histology, location, and population distribution (by age, race, and gender) are provided. Microscopically, BtL is composed of well-organized dense lamellated bone which is poorly vascularized and with very few osteocytes. It forms a dome-shaped roof over an underlying diploeized area which includes the ectocranial table. The frequency of BtL is similar in modern (37.6%) and archaeological (41.1%) populations, in blacks, whites, males, and females, and correlates with age. It is rare in nonhuman primates. Fifty-five percent of the human skulls studied by us had BtL only on the parietal, 23.6% on the frontal, and 3.6% on the occipital bones. Fifteen percent had BtL on both the frontal and parietal bones. No lateral preference was found. Most skulls with BtL (64.1%) had only one lesion, 20.4% had two BtL, and 15.4% demonstrated multiple BtL. The average number of button osteomas on an affected skull was 1.97. The frequency of large osteomas (0.5-1.0 cm) was similar in young and old age groups. The demographic characteristics of BtL, mainly its high frequency among ancient and modern populations, its independence of sex and race, its scarcity in other primates, and the fact that its macro- and microstruture are indicative of an hamartoma (and not an osteoma or exostosis) suggest an evolutionary background to the phenomenon.     

γ-Ray footprinting and fluorescence polarization anisotropy of a 30-mer synthetic DNA fragment with one 2′-deoxy-7-hydro-8- oxoguanosine lesion

The influence of the oxidative lesion 2'-deoxy-7-hydro-8-oxoguanosine (8-oxodG) on some conformational properties of DNA has been studied. Four 30-mer duplexes of the form [5'-GATCCTCTAGAGTC[G(*) or G]ACCTGCAGGCATGCA-3']:[3'-CTAGGAGATCTCAG[C or A]TGGACGTCCGTACGT-5'], in which G(*) is the 8-oxodG lesion, were synthesized in order to compare the effect of the GA mismatch and of the damaged G(*)C and G(*)A forms with the normal GC. Spectroscopic measurements performed by means of UV denaturation and circular dichroism experiments do not show gross changes of stability and overall structure in the damaged and mismatched samples. The control DNA and the samples containing GA mismatch show very similar gamma-rays cutting patterns, indicating that the introduction of the GA mismatch does not perturb the phosphate backbone geometry. In the samples containing the 8-oxodG there are some variations of the cleavage pattern near G(*) which are extended for almost one helical turn. Some differences are observed between G(*)C and G(*)A duplexes. In particular, in the G(*)C sample the reduced accessibility to OH radicals at the G15 site, observed in the control, spreads on the intrastrand adjacent bases and in the G(*)A sample a shift of the minimum is observed. The hydrodynamic radius R(h) derived by fluorescence polarization anisotropy decay exhibits a constant value of 11.4 +/- 0.2 A between 5 and 40 degrees C, in all the samples. The torsional constant alpha of each oligomer decreases when the temperature is raised and the alpha values of the damaged samples are higher than those of the normal ones.     

The yeast polyadenylate-binding protein (PAB1) gene acts as a disease lesion mimic gene when expressed in plants

We have expressed the gene (PAB1) encoding the yeast polyadenylate-binding protein (Pab1p) in tobacco. Plants that accumulate the Pab1p display a range of abnormalities, ranging from a characteristic chlorosis in leaves to a necrosis and large inhibition of growth. The severity of these abnormalities reflects the levels of yeast Pab1p expression in the transgenic plants. In contrast, no obvious differences could be seen in callus cultures between the transgene and vector control. Plants that display PAB-associated abnormalities were resistant to a range of plant pathogens, and had elevated levels of expression of a pathogenesis-related gene. These two properties – impairment of growth and induction of defense responses – indicate that the yeast PAB1 gene can act as a disease lesion mimic gene in plants.     

Effect of Initial Nematode Population Density on the Interaction of Pratylenchus penetrans and Verticillium dahliae on 'Russet Burbank' Potato

Four similar growth chamber experiments were conducted to test the hypothesis that the initial population density (Pi) of Pratylenchus penetrans influences the severity of interactive effects of P. penetrans and Verticillium dahliae on shoot growth, photosynthesis, and tuber yield of Russet Burbank potato. In each experiment, three population densities of P. penetrans with and without concomitant inoculation with V. dahliae were compared with nematode-free controls. The three specific Pi of JR penetrans tested varied from experiment to experiment but fell in the ranges 0.8-2.5, 1.8-3.9, 2.1-8.8, and 7.5-32.4 nematodes/cm³ soil. Inoculum of V. dahliaewas mixed into soil, and the assayed density was 5.4 propagules/gram dry soil. Plants were grown 60 to 80 days in a controlled environment. Plant growth parameters in two experiments indicated significant interactions between P. penetrans and V. dahliae. In the absence of V. dahliae, P. penetrans did not reduce plant growth and tuber yield below that of the nematode-free control or did so only at the highest one or two population densities tested. In the presence of K dahliae, the lowest population density significantly reduced shoot weight and photosynthesis in three and four experiments, respectively. Higher densities had no additional effect on shoot weight and caused additional reductions in photosynthesis in only one experiment. Population densities of 0.8 and 7.5 nematodes/cm³ soil reduced tuber yield by 51% and 45%, whereas higher densities had no effect or a 15% additional effect, respectively. These data indicate that interactive effects between P. penetrans and V. dahliae on Russet Burbank potato are manifested at P. penetrans population densities less than 1 nematode/cm³ soil and that the nematode population density must be substantially higher before additional effects are apparent.     

脑梗死患者的脑白质病变危险因素分析

目的：探索脑梗死患者中脑白质病变的危险因素。方法：以2012 年1 月至2014 年12 月我院神经内科收治的837 例脑梗死 患者为研究对象,采用Fazekas量表评价核磁共振T2WI脑室旁白质和皮质下白质病变严重程度。分别比较不同程度脑室旁白质 病变、皮质下白质病变患者间各个危险因素的差异,采用Logistic 回归分析脑白质病变的危险因素。结果：年龄、高血压是脑室旁 白质（OR 年龄=1.090,95%CI:0.073-0.099,P＜0.05;OR 高血压=1.699,95%CI:0.242-0.818,P＜0.05）和皮质下白质病变（OR 年龄 =1.074,95%CI:0.059-0.083,P＜0.05;OR高血压=1.353,95%CI:0.017-0.588,P＜0.05）共同的危险因素。收缩压（OR=1.008,95%CI: 0.001-0.015,P＜0.05）是皮质下白质病变的危险因素。结论：在脑梗死患者中,年龄、高血压是脑室旁白质病变、皮质下白质病变共 同的危险因素,收缩压是皮质下白质病变的危险因素。     

ST 段抬高心肌梗死靶血管长病变急诊介入治疗的安全性及疗效分析

目的:探讨ST段抬高急性心肌梗死(ST-elevation myocardial infarction,STEMI)患者靶血管长病变(病变>25 mm)急诊经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的临床疗效及安全性。方法:回顾性收集2009年1月-2010年6月因STEMI就诊于沈阳军区总医院并急诊行PCI处理的患者442例,以靶病变长度分为两组,即≤25 mm为短病变组(n=235)和>25mm为长病变组(n=207),均急诊行PCI治疗,分析和比较两组患者术前的基线资料、术中资料及并发症的发生情况、辅助措施(临时起搏、IABP、血栓抽吸装置)应用情况,术后30天、2年电话或临床随访,记录主要不良心血管事件(major adverse cardiac events,MACE)的发生情况。结果:与短病变组比较,长病变组吸烟者更多(81.6%vs 62.6%,P=0.000);以三支病变偏多(34.8%vs 24.7%,P=0.037);多枚支架使用率更高(1.47±0.63 vs 1.04±0.28,P=0.000),平均支架总长度显著增加(29.80±7.02 mm vs 22.95±5.58mm,P=0.000),手术成功率、术中并发症及辅助措施应用情况比较差异无统计学意义(P>0.05),30天及2年随访MACE的发生率比较差异无统计学意义(P>0.05)。结论:与急诊PCI治疗的STEMI短病变患者对比,长病变患者虽然病变复杂,多枚支架使用率高,平均支架总长度增加,但术中并发症、30天、2年内MACE与短病变患者相当,提示在以药物洗脱支架为主的介入治疗时代,急诊PCI处理STEMI靶血管长病变具有良好的疗效及安全性。     

Enhancement of gastric mucosal integrity by Lactobacillus rhamnosus GG

The gastric mucosa is frequently exposed to different exogenous and endogenous ulcerative agents. Alcoholism is one of the risk factors for the development of mucosal damage in the stomach. This study aimed to assess if a probiotic strain Lactobacillus rhamnosus GG (LGG) is capable of protecting the gastric mucosa from acute damage induced by intragastric administration of ethanol. Pre-treatment of rats with LGG at 10(9) cfu/ml twice daily for three consecutive days markedly reduced ethanol-induced mucosal lesion area by 45%. LGG pre-treatment also significantly increased the basal mucosal prostaglandin E(2) (PGE(2)) level. In addition, LGG attenuated the suppressive actions of ethanol on mucus-secreting layer and transmucosal resistance and reduced cellular apoptosis in the gastric mucosa. It is suggested that the protective action of LGG on ethanol-induced gastric mucosal lesions is likely attributed to the up-regulation of PGE(2), which could stimulate the mucus secretion and increase the transmucosal resistance in the gastric mucosa. All these would protect mucosal cells from apoptosis in the stomach.     

毁损大鼠中缝背核内触液神经元对吗啡依赖和戒断的影响

目的:探索脑内远位触液神经元在吗啡依赖和戒断形成过程中的作用。方法:化学性神经元毁损、侧脑室引入霍乱毒素亚单位B与辣根过氧化物酶复合物(CB-HRP)神经示踪、TMB-ST呈色反应,Western blot、nNOS免疫组织化学。结果:毁损大鼠中缝背核内远位触液神经元后,纳洛酮催促的戒断症状明显减弱,戒断症状评分较戒断未毁损组降低约38%(P<0.05);给予溶媒和毁损触液神经元旁侧的大鼠戒断症状与戒断组比较未见明显变化(P>0.05)。毁损组脑片触液神经元密集区局部细胞损坏明显,仅在其毁损区边缘观测到少量CB-HRP阳性细胞。未毁损组CB-HRP标记细胞位置及数量恒定,形态清晰。毁损触液神经元后,脊髓背角nNOS阳性神经元计数及nNOS蛋白表达较戒断未毁损组减少明显(P<0.05),而较正常组和依赖组增加仍显著(P<0.01)。结论:毁损大鼠中缝背核内部分远位触液神经元可减弱吗啡戒断症状和脊髓背角神经元型一氧化氮合酶的表达,提示中缝背核内部分远位触液神经元可能参与了吗啡依赖和戒断的形成,NO介导脑内触液神经元与脊髓水平对吗啡依赖和戒断的调节。