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．     

NLR、SII与乳腺癌患者新辅助化疗后病理完全缓解的关系

目的 分析乳腺癌患者(BC)接受新辅助化疗(NACT)后达到病理完全缓解(pathological complete response, pCR)与淋巴细胞比值(NLR)、系统免疫炎症指标(SII)的关系.方法 回顾性分析85例接受NACT的乳腺癌患者的临床资料,根据术后病理Miller-Payne(MP)分级标准判定患者的化疗疗效,即pCR与non-pCR,分析NLR、SII与乳腺癌患者新辅助化疗疗效间的关系.结果 85例符合标准的患者19例(22%)患者获得pCR;NLR与淋巴结转移显著相关(P<0.05),与患者年龄、肿瘤直径、HER-2、ER、PR、Ki-67、P53、分子分型、TNM分期无明显相关性(P>0.05);SII与患者年龄、肿瘤直径、淋巴结转移、HER-2、ER、PR、Ki-67、P53、分子分型、TNM分期无明显相关性(P>0.05).相比NLR≥1.99组患者,NLR<1.99组患者有更高的pCR率(P<0.05);相比于SII≥486.8组患者,SII<486.8组患者有更高的pCR率(P<0.05).结论 NLR、S...     

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.     

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.     

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.     

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.     

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.     

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.     

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.     

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.     

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。     

On Tragic Consciousness In The Works By Ernest Hemingway

As an American modern novelist who were famous in the literary world, Hemingway was not a person who always followed the trend but a sharp observer. At the same time, he was a tragedy maestro, he paid great attention on existence, fate and end-result. The dramatis personae's tragedy of his works was an extreme limit by all means tragedy on the meaning of fearless challenge that failed. The beauty of tragedy was not produced on the destruction of life, but now this kind of value was in the impact activity. They performed for the reader about the tragedy on challenging for the limit and the death.     

Achieving Unusual States of Matter Under High Pressure

正The periodicity of the elements and the non-reactivity of the inner-shell electrons are two related principles of chemistry,rooted in the atomic shell structure.Within compounds,Group I elements,for example,invariably assume the+1 oxidation state,and their chemical properties differ completely from those of the p-block elements.These general rules govern our understanding of chemical structures and reactions.Using first principles calcula-     

Exchange-Correlation and Electronic Excitation Energies from Pairing Matrix Fluctuations

We have developed an adiabatic connection to formulate the ground-state exchange-correlation energy in terms of pairing matrix linear fluctuations.This formulation of the exchange-correlation energy opens a new channel for density functional approximations based on the many-body perturbation theory.We illustrate the potential of such approaches with an approximation based on the particle-particle Random Phase Approximation(pp-RPA).This re-     

Density Functional Theory for the Response of Periodic Systems to Electric Fields Based on the Vector Potential Approach

正The electronic and nuclear(structural/vibrational)response of 1D-3D nanoscale systems to electric fields gives rise to a host of optical,mechanical,spectral,etc.properties that are of high theoretical and applied interest.Due to the computational difficulty of treating such large systems it is convenient to model them as infinite and periodic(at least,in first approximation).The fundamental theoretical/computational problem in doing so is that     

On the Thermodynamic Limit for Responses to Static Electromagnetic Fields

For molecular systems,the quantum-mechanical treatment of their responses to static electromagnetic fields usually employs a scalar-potential treatment of the electric field and a vector-potential treatment of the magnetic field.Although the potential for each field separately is associated with the choice of an(unphysical)origin,the precise choice of the origin for the electrostatic field has little consequences for the results.This is different for the