乳腺病变伴发生物矿化的类型及机制研究

乳腺病变伴发生物矿化的类型多样、机制复杂。本试验对手术切除或粗针穿刺获得的乳腺脂肪坏死标本5例、乳腺增生症8例、乳腺纤维腺瘤7例及乳腺浸润性癌或原位癌6例分别进行常规HE（苏木素-伊红）染色、普鲁士蓝、茜素红S、Masson三色特殊染色及Ⅲ型胶原、Ⅳ型胶原免疫组织化学染色,以观察各种病变伴发矿化的常规病理学改变及无机、有机成分的差异。染色结果显示各种矿化物的主要无机成分均为钙盐。脂肪坏死和纤维腺瘤伴发的矿化均与Ⅲ型胶原有关,乳腺增生症伴发的矿化与Ⅳ型胶原有关,而乳腺导管原位癌矿化与上述两种胶原的关系不大。根据形态可将乳腺病变伴发的生物矿化分为坏死相关性矿化及非坏死相关性矿化。前者又可分为肿瘤性坏死相关性矿化和非肿瘤性坏死相关性矿化。非坏死相关性矿化可分为上皮相关性矿化及间质相关性矿化。乳腺病变类型不同,其伴发矿化的机制也不尽相同。     

复方皂角刺膏外敷治疗原发性肝癌重度癌性疼痛28 例临床观察

目的：观察复方皂角刺膏外敷治疗肝癌重度癌性疼痛的临床疗效。方法：将肝癌重度癌性疼痛患者56 例随机分为治疗组和对照组,每组各28 例。对照组予以盐酸羟考酮缓释片治疗,治疗组在对照组基础上加用复方皂角刺膏外敷治疗,疗程均为7 d。观察2组的疼痛强度、使用阿片类止痛药剂量、爆发痛次数及健康状况。结果：总有效率治疗组为92.86%（26/28）,对照组为71.43%（20/28）,2组比较,差异有统计学意义（P<0.05）。与治疗前比较,2组治疗后数字分级法（NRS）评分、Karnofsky功能状态（KPS）评分均改善,且治疗组改善程度优于对照组（P<0.05或P<0.01）。2组治疗第1天止痛药剂量比较,差异无统计学意义（P>0.05）;治疗后治疗组止痛药剂量较对照组减少（P<0.05）。治疗组爆发痛次数少于对照组（P<0.05）。结论：复方皂角刺膏外敷治疗肝癌重度癌性疼痛的镇痛效果明显,能减少阿片类止痛药剂量与爆发痛次数,提高患者生活质量。     

花岗岩、氡气与人类肺癌

氡作为唯一具有放射性的惰性气体,其危害性被医学研究所证实。世界卫生组织研究报告表明,氡气及其放射性子体的吸入是除吸烟因素之外人类肺癌的第一大致病因子,全球不同国家中大概3%到15%的肺癌是由氡气辐射造成的,氡气与吸烟的协同效应还会使得吸烟者患肺癌的几率大增。此外,过量氡气吸入还能破坏人的神经系统,造成白细胞减少,导致血凝增加和高血糖症状。氡是U-238衰变而来,而花岗岩是U主要赋存岩石之一。花岗岩是大陆地壳主要成分,约占地壳体积的22%。花岗岩的成因在地质学界研究较多,但花岗岩与人类肺癌的关联却没有引起地质工作者足够多的关注;医学界对氡的危害了解较多,但对氡的来源和花岗岩的关系却知之甚少。本文致力于阐明花岗岩与氡气形成的内在逻辑关系,并为公众科普氡气及其危害。     

Lifetime risk of urothelial carcinoma and lung cancer in the arseniasis-endemic area of Northeastern Taiwan

Arsenic in drinking water has been shown to increase the risk of urothelial carcinoma and lung cancer. However, the lifetime risk of developing urothelial carcinoma and lung cancer caused by exposure to arsenic in drinking water has not been reported. This study aimed to assess the lifetime risk of urothelial carcinoma and lung cancer caused by arsenic exposure from drinking water and cigarette smoking habit for residents living in the arseniasis-endemic area in Northeastern Taiwan. We recruited 8086 residents in 1991–1994 and monitored them for their newly developed types of cancers, identified by computerized linkage with the national cancer registry profile. There were 37 newly diagnosed urothelial carcinoma cases and 223 new lung cancer cases during the follow-up period (until 2007). The lifetime (35–85 years old) cumulative risk of developing urothelial carcinoma from an arsenic concentration in the drinking water of <10, 10–99, and 100+ μg/L was 0.29%, 1.07% and 3.43%, respectively. The corresponding probabilities were 7.42%, 8.99% and 17.09% for the lifetime risk of developing lung cancer. Cigarette smoking was associated with an increased risk of urothelial carcinoma and lung cancer, showing the hazard ratio (95% confidence interval) of 2.48 (1.27–4.82) and 3.44 (2.00–5.90) after adjusting for the arsenic concentration in drinking water. After adjusting for cigarette smoking, the hazard ratio (95% confidence interval) of developing urothelial carcinoma caused by the arsenic concentration in drinking water of <10, 10–99 and 100+ μg/L was 1.0 (the reference group), 2.18 (0.59–8.01), and 8.71 (2.49–30.48), respectively. The corresponding figures were 1.0 (the reference group), 1.14 (0.80–1.61), 1.84 (1.28–2.65) for lung cancer. Synergistic effects on the development of urothelial carcinoma and lung cancer existed between the arsenic exposure level and cigarette smoking. It is suggested that people who have had a high exposure to arsenic in drinking water should stop smoking cigarettes to lower their lifetime risk of urothelial carcinoma and lung cancer.     

Arsenic in drinking and lung cancer mortality in Taiwan

The association between exposure to arsenic in drinking water and lung cancer has been observed in some epidemiology studies, but dose–response data are limited. To assess the dose–response relationship and identify hot spots, we analyzed the national death registry data of Taiwan from 1971 to 2000. We adopted data on 311 townships gathered by a nationwide survey of drinking water and divided arsenic levels into three groups: below 0.05 mg/L, 0.05–0.35 mg/L, and above 0.35 mg/L. Using the direct standardization method to adjust for the effects of age, we calculated the standardized mortality rates of lung cancer in both genders and evaluated their associations with arsenic levels. We also used the geographical information system to identify the hot spots. During the 30-year study period, we identified 64,954 male and 27,039 female lung cancer deaths in the study townships. We found significant increases in lung cancer mortality associated with arsenic levels above 0.35 mg/L in both genders, but the increases associated with levels between 0.05 and 0.35 mg/L were statistically significant in men only. Using both 0.05 and 0.35 mg/L as the cut-offs, we found most of the hot spots were in the southwestern coast and northeastern areas, but the southwestern coast area had some hot spots where the percentages of high risk population were higher than any hot spots in the northeastern area.     

羧甲基琼胶寡糖钒络合物抗氧化及抑制BEL-7402 癌细胞增殖的研究

制备了羧甲基琼胶寡糖钒络合物,并利用ICP-MS测定钒的含量为4.6%;同时,对钒氧羧甲基琼胶寡糖抗氧化和抑制人肝癌BEL-7402细胞增殖活性进行研究。抗氧化实验结果表明,钒氧羧甲基琼胶寡糖清除?OH的能力和DPPH?的能力均比羧甲基琼胶寡糖的清除能力有显著提高。经磺酰罗丹明B蛋白染色法测试,进一步发现钒氧羧甲基琼胶寡糖在16~1 000 mg/L浓度范围内对人肝癌BEL-7402细胞的增殖有较好的抑制作用。     

A Comparison of Design-Based and Model-Based Analysis of Sample Surveys in Geography

Sample surveys are routinely used to gather primary data in human geography research. We highlight the difference between design-based analysis and model-based analysis of sample surveys and emphasize the advantages of using the design-based approach with these data. As an example, we demonstrate differences in results from model-based and design-based analyses of cancer prevalence in a population of predominantly minority women in North Carolina and South Carolina. The results from the two approaches reveal differences in population estimates of numerous variables and a different conclusion regarding the significance of an explanatory variable in a logistic regression model to explain colon cancer prevalence.     

乳腺钼靶上含钙化占位性病变的动态增强MRI研究

目的:探讨动态增强MRI对乳腺钼靶上含钙化占位性病变的诊断价值。资料与方法:回顾性分析101例乳腺含钙化占位性病变的钼靶及MRI检查资料。其中,乳腺恶性占位性病变56例,包括浸润性导管癌46例,导管原位癌3例,小叶原位癌2例,粘液腺癌3例,基底细胞癌1例,肌上皮癌1例;乳腺良性占位性病变45例,包括乳腺纤维腺瘤39例,乳腺囊肿4例,乳腺纤维囊性增生2例。根据钼靶上钙化形态对于良恶性病变的判断标准,将钙化分为典型良性、可疑恶性、高度可能恶性三类。将钼靶和MRI的诊断结果与病理诊断结果进行对照。以病理结果为金标准,对钼靶与MRI的诊断结果进行配对四格表χ2检验统计学分析。结果:本组85例患者(84.2%)根据钼靶所见做出正确诊断。16例患者(15.8%)钼靶提示可疑恶性钙化但未能确诊或误诊,其中14例在MRI检查后做出正确诊断。MRI检查做出正确诊断99例(98.0%)。钼靶和MRI检查对本组含钙化乳腺占位性病变的诊断准确率差异有统计学意义(P=0.0005,P<0.O5)。结论:当钼靶上钙化信息不能明确乳腺占位性病变的性质,特别在钙化归为BI-RADS3和BI-RADS4级乳腺疾病时,动态增强MRI可以提高诊断准确性。     

CT扫描层厚和增强对I期非小细胞肺癌形态学测量的影响

目的：探讨CT扫描层厚、增强与否对I期非小细胞肺癌（NSCLC）三维最大径、体积及质量的影响。方法：92例I期NSCLC患者,其中76例在平扫基础上进行了增强扫描;扫描数据传至CT后处理工作站,采用计算机辅助诊断软件描绘并分割病灶,分别自动测量2nlm、7inn层厚及7nlm增强前后病灶的最大径d（mm）、体积V（mm3）、质量m（g）,计算各均值及方差,运用配对T检验评价不同层厚、增强与否对肿瘤的三维测量结果有无统计学差异。结果：2into、7mm层厚CT扫描条件下,d、玖m的测量结果具有显著统计学差异（P〈0．05）;7mm层厚扫描条件下,cT增强前后d、V的测量无显著统计学差异（P〉0．05）,m的测量具有显著统计学差异（P〈0．05）。结论：胸部cT扫描2mm、7mm层厚的选取对I期NSCLC三维最大径、体积及质量的测量结果具有一定的影响;CT增强可影响肿瘤的质量测量评价。     

Two measures of progress in adapting to climate change

Adaptation will play a key role in determining the economic and social costs of climate change. One important measure of adaptation is reductions in deaths caused by climate events. This paper uses two new data sets to test the hypothesis that, in recent years, climate events cause less deaths than in the past. Using data on deaths caused by natural disasters and data on skin cancer death rates in warmer and cooler US states, this paper reports evidence in favor of the adaptation progress hypothesis.