我国青年女性乳腺癌的临床和病理特点

目的 探讨我国青年女性乳腺癌的临床和病理特点.方法 全面收集国内关于青年女性乳腺的临床研究论文.青年女性(≤35岁)乳腺癌患者为研究组,＞35岁以上女性乳腺癌患者为对照组.结果 共检索符合纳入标准及排除标准的论文8篇,包括4881例病例,研究组发病至就诊时间明显长于对照组.采用随机效应模型进行meta分析,两组的TNM分期、腋窝淋巴结转移、免疫组化有显著差异,病理分型、5年生存率无明显差异.结论 青年女性乳腺癌虽然更多发生腋窝淋巴结转移,TNM分期较晚,ER阳性率低,但经积极治疗,可能取得与中老年女性乳腺癌一样的效果,年龄不是影响预后的独立因素.     

乳腺癌四个分子亚型与腋窝淋巴结转移的相关性研究

目的探讨乳腺癌四个分子亚型与腋窝淋巴结转移的相关性.方法选取乳腺癌患者264例,根据雌激素受体、孕激素受体、表皮生长因子受体2(Her-2)的表达,将其分为Luminal A型、Luminal B型、HER-2过表达型、Triple-negative型四个分子亚型,比较不同分子亚型之间腋窝淋巴结转移率的差异,并对影响腋窝淋巴结转移的相关因素进行多因素Logistic回归分析.结果 HER-2过表达型腋窝淋巴结转移率最高,其次为Luminal B型,不同分子亚型乳腺癌的腋窝淋巴结转移率之间差异具有统计学意义(P0.05).年龄和月经状态在腋窝淋巴结转移率之间差异无统计学意义(P0.05),浸润性小叶癌和导管癌较其他病理类型乳腺癌的淋巴结转移率明显增高;肿瘤直径大于5 cm后,淋巴结转移率明显增加,差异均具有显著统计学意义(P0.01).多因素回归分析显示:肿瘤大小、是否为Luminal A型、是否为浸润性导管癌、浸润性小叶癌为腋窝淋巴结转移的独立危险因素.结论 HER-2过表达型和Luminal B型乳腺癌腋窝淋巴结转移率较高;肿瘤大小、分子分型、病理类型为影响腋窝淋巴结转移的独立危险因素.     

脂肪溶解液用于乳腺癌腋窝淋巴结解剖

目的:探讨脂肪溶解液预处理在解剖乳腺癌腋窝淋巴组织标本中的应用价值并分析影响解剖结果的因素.方法:施行乳腺癌改良根治术患者156例,实验组80例,予脂肪溶解液浸泡15~20 min后进行解剖,对照组76例按照传统方法解剖.比较两组在解剖淋巴结的数目及解剖时间等方面的差异,进一步分析年龄、肥胖及淋巴结分期等因素对解剖结果的影响.结果:实验组解剖淋巴结的数目(23.69)明显多于对照组(18.56),解剖时间(19.83 min)明显少于对照组(24.15 min).分层分析发现年龄和淋巴结的转移数目对两组间淋巴结解剖结果的差异无影响;肥胖对解剖结果的差异影响较大,特别是肥胖患者两组间检出淋巴结数目的差值(7.12)显著高于非肥胖患者(3.67).结论:脂肪溶解液处理腋窝淋巴结可增加腋窝淋巴结解剖的数目,降低解剖难度,尤其适用于肥胖患者,此方法的解剖效果与年龄及淋巴结分期无关.     

乳腺癌DCE-MRI定量参数及IVIM评估腋窝淋巴结转移的价值分析

探讨乳腺癌DCE-MRI定量参数及IVIM参数在预测腋窝淋巴结转移中的价值。分析经病理证实为乳腺癌并同时行腋窝淋巴结清扫、前哨淋巴结活检或穿刺活检证实淋巴结是否转移的乳腺癌灶的DCE-MRI及IVIM资料,并将其分为腋窝淋巴结转移组及无转移组,比较分析2组乳腺癌的DCE-MRI定量参数及IVIM参数,以评价其对腋窝淋巴结是否存在转移的预测价值。结果:K~(trans)值在2组间存在统计学差异,转移组的K~(trans)值低于无转移组(P=0.042),K_(ep)及V_e值在2组中差异无统计学意义(P0.05);半定量参数IAUGC、Maxslope值、CER值差异无统计学意义(P0.05);IVIM值与ADC值差异均无统计学意义(P0.05)。结论:乳腺癌DCE-MRI参数及IVIM参数、ADC值对腋窝淋巴结状态评估的价值有限。     

放射性核素显像联合蓝染法在探测乳腺癌前哨淋巴结中的应用研究

目的：探讨用放射性核素（^99mTc-SC，^99m锝-硫胶体）显像联合染料法探测前哨淋巴结（SLN）在乳腺癌外科定位前哨淋巴结中的作用．方法：体检无腋窝淋巴结转移的乳腺癌患者300例，均为女性，分为两组：一组用^99mTc-SC显像联合蓝染料法；一组单独使用蓝染料法对比，两组进行SLN检出率比较，并判断以SLN病理结果推断腋窝淋巴结（ALN）累及状况的可行性．结果：单纯蓝染料法对SLN检出率为96．4％，放射性核素联合蓝染组检出率为100％．SLN有转移者为28．7％，ALN有转移者为32．8％．结论：放射性核素显像联合蓝染法在探测乳腺癌前哨淋巴结的成功率高于单纯蓝染料法．SLN与ALN二者之间转移情况无明显差异．     

乳腺癌患者细胞免疫指标的检测及意义

目的检测乳腺癌患者外周血T淋巴细胞总数及CD4~+T细胞、CD8~+T细胞、CD45RA~+T细胞、CD45RO~+T细胞等T淋巴细胞亚群的百分率,用以评价患者的免疫状态.方法选择女性原发性乳腺肿瘤患者50例为病例组,并以病理检查的TNM分期结果做进一步分组,其中乳腺癌Ⅰ期27例,乳腺癌Ⅱ+Ⅲ期23例;选择女性健康体检者40例为健康对照组.应用流式细胞仪,分别检测各组外周血T淋巴细胞亚群的数量,统计分析各组检测结果的差异性.结果乳腺癌Ⅱ+Ⅲ期组CD3~+T细胞和CD4~+T细胞百分率明显低于正常对照组和乳腺癌Ⅰ期组,差异具有统计学意义(P0.05);乳腺癌Ⅰ期组CD45RA~+T细胞明显低于正常对照组,乳腺癌Ⅱ+Ⅲ期组CD45RA~+T细胞明显低于乳腺癌Ⅰ期组,差异具有统计学意义(P0.05);乳腺癌Ⅰ期组CD45RO~+T细胞明显高于正常对照组,乳腺癌Ⅱ+Ⅲ期组CD45RO~+T细胞明显高于乳腺癌Ⅰ期组,差异具有统计学意义(P0.05).结论T细胞亚群检测是评价肿瘤患者细胞免疫功能的重要指标,具有重要的临床应用价值.乳腺癌患者免疫功能与肿瘤恶变的发生、发展、临床分期有一定相关性,随着病情的进展,机体免疫功能呈现下降趋势.     

乳腺癌改良根治术保留肋间臂神经对患者感觉变化及生活质量影响

目的探讨乳腺癌行改良根治术患者行腋窝淋巴结清扫时保留肋间臂神经(ICBN)的临床价值.方法根据数字表法及患者意愿将行改良根治术的60例乳腺癌患者分为研究组(保留ICBN)及对照组,比较两组患者术后感觉变化及生存质量的差异.结果两组患者在术后1个月、术后3个月、术后6个月感觉迟钝、感觉异常方面比较差异无统计学意义(P0. 05).两组患者触觉变化在术后6个月开始有差异(P0. 05),两组患者痛觉变化在术后3个月、术后6个月均有差异(P0. 05),研究组患者的腋窝触觉与痛觉面积减退更加明显.结论在行乳腺癌改良根治术患者中保留ICBN具有长期腋窝触觉及痛觉面积减退的优点,可改善患者术后的生存质量.     

缺乏核素示踪的早期乳腺癌前哨淋巴结活检方法临床研究

目的探讨应用亚甲蓝单示踪剂行缺乏核素示踪的早期乳腺癌前哨淋巴结活检(SLNB)的临床经验.方法收集行全乳切除手术或保乳手术的早期乳腺癌患者109例(0期12例,Ⅰ期27例,ⅡA期28例,ⅡB期10例)为研究对象,所有患者通过临床和影像学检查评估腋窝淋巴结阴性状态,对其行亚甲蓝示踪前哨淋巴结活检(SLNB)、非前哨淋巴结活检(Non-SLNB)和腋窝淋巴结清扫(ALND)的患者资料进行分析,所有前哨淋巴结(SLN)、非前哨淋巴结(Non-SLN)和腋窝淋巴结(ALN)均行病理学和免疫组化检查.结果 SLN检出率、假阴性率、准确性、阴性预测值分别为97.24%,6.9%,98.1%,97.5%.病理N分期的SLN检出率间比较差异具有统计学意义(P0.05).结论应用亚甲蓝单示踪法行SLNB能准确预测缺乏核素示踪的早期乳腺癌腋窝淋巴结状态,本研究入组的病例提示前哨淋巴结的检出率和准确率与乳腺癌的N分期相关.     

合并第二原发癌的乳腺癌患者的病理特征及预后

目的:分析患第二原发癌的乳腺癌患者的临床病理特征及预后因素.方法:将19例患第二原发癌的乳腺癌患者作为试验组,选取同期19列单纯乳腺癌患者作为对照组,对比两组患者年龄、TNM分期、增殖细胞相关核抗原(Ki-67)、雌激素受体(ER)、孕激素受体(PR)、表皮生长因子受体-2(HER-2)表达及生存率间的差异.结果:实验组中6例(31.58%)再发妇科系统恶性肿瘤.实验组与对照组比较诊断年龄更大(P=0.02),实验组比对照组乳腺癌TNM分期更晚(P=0.008).对照组比实验组的存活率更高(P=0.017).结论:老年乳腺癌患者更易再发恶性肿瘤,第二原发癌患者的原发乳腺癌的TNM分期较高.患第二原发癌的患者比单纯乳腺癌患者预后差,多原发肿瘤患者的预后取决于第二原发肿瘤的类型.     

前哨淋巴结阳性患者腋下转移淋巴结分布规律的临床研究

目的研究前哨淋巴结阳性患者施行腋淋巴结清扫应用新的腋下组分区法时转移淋巴结的分布规律.方法选取83例前哨淋巴结阳性的乳腺癌患者常规施行腋窝淋巴结清除术,术后将腋下组淋巴结严格按新设定的分组标准分成A,B,C,D四区,并将各区淋巴结分别装袋送术后病理,研究不同前哨淋巴结阳性个数的乳腺癌患者每个区域检出和转移淋巴结的个数及分布规律.结果各区淋巴结检出数和阳性率均存在存在明显差异,D区B区检出淋巴结最多,分别占总数的36.1%(612/1 693)和29.1%(492/1 693),阳性率最高的为B区(37,8%),D区最低(0.5%).结论前哨淋巴结阳性患者施行腋淋巴结清扫转移淋巴结最常见的区域为B区(阳性率37.8%)和A区(阳性率11.5%),也就是胸背脉管束内侧区域,出现最少的区域为D区(阳性率0.49%),而在前哨淋巴结2枚以下阳性组D区未发现转移淋巴结.     

Markedness and its Interpretation in Language Use

Language markedness is a common phenomenon in languages, and is reflected from hearing, vision and sense, i.e. the variation in the three aspects such as phonology, morphology and semantics. This paper focuses on the interpretation of markedness in language use following the three perspectives, i.e. pragmatic interpretation, psychological interpretation and cognitive interpretation, with an aim to define the function of markedness.     

Lower Paleozoic oil relationships within Williston Basin, Canada

The Williston Basin is a significant petroleum province, containing oil production zones that include the Middle Cambrian to Lower Ordovician, Upper Ordovician, Middle Devonian, Upper Devonian and Mississippian and within the Jurassic and Cretaceous. The oils of the Williston Basin exhibit a wide range of geochemical characteristics defined as "oil families", although the geochemical signature of the Cambrian Deadwood Formation and Lower Ordovician Winnipeg reservoired oils does not match any "oil family". Despite their close stratigraphic proximity, it is evident that the oils of the Lower Palaeozoic within the Williston Basin are distinct. This suggests the presence of a new "oil family" within the Williston Basin. Diagnostic geochemical signatures occur in the gasoline range chromatograms, within saturate fraction gas chromatograms and biomarker fingerprints. However, some of the established criteria and cross-plots that are currently used to segregate oils into distinct genetic families within the basin do not always meet with success, particularly when applied to the Lower Palaeozoic oils of the Deadwood and Winnipeg Formation.     

An Analysis of Catherine＇s Character——Wuthering Heights

Wuthering Heights, Emily Bronte＇s only novel, was published in December of 1847 under the pseudonym Ellis Bell. The book did not gain immediate success, but it is now thought one of the finest novels in the English language. Catherine is the key character of this masterpiece, because everybody and everything center on her though she had a short life. We can understand this masterpiece better if we know Catherine well.     

Characterization of Ordovician carbonate reservoirs, southeastern Saskatchewan, Canada

The discovery of the prolific Ordovician Red River reservoirs in 1995 in southeastern Saskatchewan was the catalyst for extensive exploration activity which resulted in the discovery of more than 15 new Red River pools. The best yields of Red River production to date have been from dolomite reservoirs. Understanding the processes of dolomitization is, therefore, crucial for the prediction of the connectivity, spatial distribution and heterogeneity of dolomite reservoirs.The Red River reservoirs in the Midale area consist of 3～4 thin dolomitized zones, with a total thickness of about 20 m, which occur at the top of the Yeoman Formation. Two types of replacement dolomite were recognized in the Red River reservoir: dolomitized burrow infills and dolomitized host matrix. The spatial distribution of dolomite suggests that burrowing organisms played an important role in facilitating the fluid flow in the backfilled sediments. This resulted in penecontemporaneous dolomitization of burrow infills by normal seawater. The dolomite in the host matrix is interpreted as having occurred at shallow burial by evaporitic seawater during precipitation of Lake Almar anhydrite that immediately overlies the Yeoman Formation. However, the low δ18O values of dolomited burrow infills (-5.9‰～ -7.8‰, PDB) and matrix dolomites (-6.6‰～ -8.1‰, avg. -7.4‰ PDB) compared to the estimated values for the late Ordovician marine dolomite could be attributed to modification and alteration of dolomite at higher temperatures during deeper burial, which could also be responsible for its 87Sr/86Sr ratios (0.7084～0.7088) that are higher than suggested for the late Ordovician seawaters (0.7078～0.7080). The trace amounts of saddle dolomite cement in the Red River carbonates are probably related to "cannibalization" of earlier replacement dolomite during the chemical compaction.     

Features of Women's language

Language is a means of verbal communication. People use language to communicate with each other. In the society, no two speakers are exactly alike in the way of speaking. Some differences are due to age, gender, statue and personality. Above all, gender is one of the obvious reasons. The writer of this paper tries to describe the features of women＇s language from these perspectives： pronunciation, intonation, diction, subjects, grammar and discourse. From the discussion of the features of women＇s language, more attention should be paid to language use in social context. What＇s more, the linguistic phenomena in a speaking community can be understood more thoroughly.     

Design and analysis of generic LBS application developing platform

Location based services is promising due to its novel working style and contents.A software platform is proposed to provide application programs of typical location based services and support new applications developing efficiently. The analysis shows that this scheme is easy implemented, low cost and adapt to all kinds of mobile nework system.     

橡胶颗粒沥青混合料低温抗裂性试验研究

以AC-13级配为基础,将橡胶颗粒代替部分集料掺入混合料中,以低温弯曲试验为评价方法对不同橡胶颗粒掺量下沥青混合料的低温抗裂性进行研究,并引入应变能密度值对混合料的低温抗裂性进行综合评价.试验结果表明:橡胶颗粒沥青混合料试件的破坏微应变均超过2 300,满足冬寒区的技术指标;无论是否掺加橡胶颗粒,随着温度的下降,沥青混合料破坏时的最大弯拉强度增大,弯拉应变降低,劲度模量增大;弯曲应变能密度在胶粒掺量为1%左右时具有较大的弯曲应变能密度值,此时橡胶颗粒沥青混合料具有较好的低温抗裂性.     

A computer generator for randomly layered structures

AcomputergeneratorforrandomlylayeredstructuresYUJia shun1,2,HEZhen hua2(1.TheInstituteofGeologicalandNuclearSciences,NewZealand;2.StateKeyLaboratoryofOilandGasReservoirGeologyandExploitation,ChengduUniversityofTechnology,China)Abstract:Analgorithmisintrod…     

低渗透非均质砂岩油藏启动压力梯度研究

理论推导与室内实验相结合,建立了低渗透非均质砂岩油藏启动压力梯度确定方法。首先借助油藏流场与电场相似的原理,推导了非均质砂岩油藏启动压力梯度计算公式。其次基于稳定流实验方法,建立了非均质砂岩油藏启动压力梯度测试方法。结果表明:低渗透非均质砂岩油藏的启动压力梯度确定遵循两个等效原则。平面非均质油藏的启动压力梯度等于各级渗透率段的启动压力梯度关于长度的加权平均;纵向非均质油藏的启动压力梯度等于各渗透率层的启动压力梯度关于渗透率与渗流面积乘积的加权平均。研究成果可用于有效指导低渗透非均质砂岩油藏的合理井距确定,促进该类油藏的高效开发。     

Quantitative trait loci （QTLs） for quality traits related to protein and starch in wheat

Quality traits in wheat （Triticum aestirum L.） were studied by quantitative trait locus （QTL） analysis in a recombinant inbred line （RIL） population, a set of 131 lines derived from Chuan 35050 × Shannong 483 cross （ChSh）. Grains from RILs were assayed for 21 quality traits related to protein and starch. A total of 35 putative QTLs for 19 traits with a single QTL explaining 7.99-40.52% of phenotypic variations were detected on 10 chromosomes, 1D, 2A, 2D, 3B, 3D, 5A, 6A, 6B, 6D, and 7B. The additive effects of 30 QTLs were positive, contributed by Chuan 35050, the remaining 5 QTLs were negative with the additive effect contributed by Shannong 483. For protein traits, 15 QTLs were obtained and most of them were located on chromosomes 1 D, 3B and 6D, while 20 QTLs for starch traits were detected and most of them were located on chromosomes 3D, 6B and 7B. Only 7 QTLs for protein and starch traits were co-located in three regions on chromosomes 1D, 2A and 2D. These protein and starch trait QTLs showed a distinct distribution pattern in certain regions and chromosomes. Twenty-two QTLs were clustered in 6 regions of 5 chromosomes. Two QTL clusters for protein traits were located on chromosomes 1D and 3B, respectively, three clusters for starch traits on chromosomes 3D, 6B and 7B, and one cluster including protein and starch traits on chromosome 1D.