Objective To evaluate the effectiveness of thermal tomography in breast cancer (BC) screening. Methods We conducted a general population-based BC screening in three regions of Hubei Province (Xiantao, Hongan, and Yangxin Districts). Participants underwent a questionnaire-based interview for baseline data collection. They then received a physical examination, thermal tomography, and ultrasound from doctors and technicians. We compared the efficacies, including sensitivity, specificity, and false-positive rates, of ultrasound and thermal tomography in BC screening. Results A total of 59 712 eligible women were included in this screening program. The BI-RADS 1, 2, 3, 4, and 5 accordance rates between the two screening methods were 0.9549, 0.8047, 0.9037, 0.3352, and 0, respectively. The overall accordance rate was 0.933 1. The kappa consistency results showed that the Cicchetti-Allison and Fleiss-Cohen kappa values were 0.7970 and 0.8583, respectively. Although the two methods had equal sensitivities, specificity was higher in thermal tomography than in ultrasound. The false-positive rate was lower in thermal tomography than in ultrasound. The area under the receiver operating characteristic (ROC) curve of thermal tomography was significantly larger than that of ultrasound. Conclusion The general consistency between thermal tomography and ultrasound in BC screening was high. Thermal tomography outperformed ultrasound in terms of specificity and diagnostic efficiency. Therefore, thermal tomography has a high application value for general population-based BC screening.

Objective:To study the actual effect of the use of personal protective equipment of the examined individuals, and provide reference and basis for the correct use of personal protective equipment and the radiological health administrative law enforcement.Methods:From February to June 2022, the imaging department of Qingdao Municipal Hospital selected 170 patients who underwent X-ray imaging examination (oral panoramic, dental radiography, DR photography, CT scanning), including 25 with oral panoramic and dental radiography, 60 with CT scanning and 60 with DR imaging. The thermoluminescent dosimeter was used to detect the ambient dose equivalent at the point of concern for 170 examined individuals who have used personal protective equipment to cover their sensitive parts, and to analyze the data detected at the same point as above when routinely using the same equipment.Results:There was a statistically significant difference in the dose equivalent at the same points inside and outside the lead neckband ( t=-2.23, P<0.05). There was no statistically significant difference in the dose equivalent at the same point inside and outside the lead collar during dental radiography ( P>0.05). During DR photography (chest PA, lateral and lumbar AP), the examined individuals were wearing lead aprons. Among them, there was a statistically significant difference in the dose equivalent at the same points inside and outside the lead aprons of children′s chest PA and adults′ chest PA ( U=10.00, 19.00, P<0.05). There was no statistically significant difference in the dose equivalent at the same points inside and outside the lead aprons of adult′s chest PA and lumbar AP ( P>0.05). When performing CT scan (chest or upper abdomen), there was a statistically significant difference in the dose equivalent at the same points of wrapped lead aprons( U=878.50, 11.00, P<0.05). Conclusions:The correct use of personal protective equipment is a complex technical problem. It is very important to fully and accurately understand the optimization principle of radiation protection and correctly use personal protective equipment for the examined individuals. The administrative punishment of radiation health on the use of personal protective equipment of the examined individuals should be cautious.

欧阳洋，李娟娟，涂毅，孙圣荣（武汉大学人民医院 乳腺甲状腺外科，湖北 武汉 430060） [摘 要] 目的：借助多种癌症生物信息数据库研究乳腺癌组织中缺氧诱导因子1亚基α（HIF1A）的表达水平及其与乳腺癌患者预后及肿瘤免疫细胞浸润的关系。方法：利用Oncomine、人类蛋白质图谱、基因表达谱交互式分析（GEPIA）及TCGA数据库分析HIF1A基因在乳腺癌组织中的表达及其与患者预后、临床病理特征的关系，并在中国人乳腺癌组织标本（选用2011年1月至2015年12月中国武汉大学人民医院手术切除的93例乳腺癌组织和14例良性乳腺疾病组织）中进行验证。对HIF1A高低表达组间的差异基因进行基因本体（GO）和京都基因与基因组百科全书（KEGG）富集分析，用Cibersort R软件评估HIF1A高低表达样本中免疫细胞浸润丰度差异。结果：生物信息数据显示，HIF1A在乳腺癌组织中高表达，预示着患者DFS预后更好（P<0.05）。HIF1A的表达与雌激素受体（ERP）、孕激素受体（PR）和人表皮生长因子受体2（HER2）表达相关（均P<0.05）。GO生物功能及KEGG通路富集分析结果提示，HIF1A可能参与肿瘤免疫调节等生物活动。使用Cibersort分析结果显示，HIF1A与肿瘤免疫细胞浸润之间具有相关性（均P<0.01），发现活化记忆CD4 + T细胞、M0和M1型巨噬细胞与HIF1A表达呈正相关，在乳腺癌组织中高表达，Treg细胞、活化NK细胞、M2型巨噬细胞与HIF1A表达呈负相关（均P<0.01）。结论：HIF1A参与调节肿瘤微环境的免疫活性，与乳腺癌患者DFS相关，其可能成为乳腺癌分级诊断、免疫治疗和预后判断的生物标志物。

With the application of high throughput sequencing and other technologies, in recent years people have found that bacteria are not only the causative factors of common breast diseases such as mastitis, but also may be involved in the occurrence and development of breast cancer. There are unique bacterial communities in the internal tissues of the breast, and their existence may be related to the incidence of breast cancer. Recent studies have found that intestinal flora may also affect the incidence of breast cancer by regulating estrogen and other pathways. Further exploration of the influence of bacteria on breast cancer will provide new ideas for diagnosis and treatment of breast cancer.

The treatment of breast cancer is becoming more individualized and minimally invasive,which makes sentinel lymph node biopsy becoming the standard treatment for axillary in patients with early-stage breast cancer who are negative in clinical axillary lymph nodes.Tracers image sentinel lymph nodes or lymphatic vessels for the successful detection of sentinel lymph node biopsy.Tracers selection is also more diverse,such as nano carbon mixed suspension,methylene blue,radioisotope,indocyanine green,etc.Different tracers and combined applications have their advantages and limitations.As for the selection of tracing methods,many factors need to be weighed.

Ductal carcinoma in situ (DCIS) is a precursor of invasive ductal breast cancer,and up to 40％ of these lesions will progress to invasive disease if untreated.The micro-environment,genetic aberrations,signal pathways and epigenetics play important roles during the infiltration and transformation of DCIS.Further studies of the infiltration and transformation of DCIS will promote the accurate assessment and prognosis prediction of the patients with DCIS,for finding a comprehensive evaluation standard and the balance between the over and low treatment.

Objective To compare the clinical evaluation in diagnosis of thyroid nodules between fine needle aspiration(FNA) and core needle biopsy(CNB).Methods 82 cases with thyroid nodules undergoing FNA and 33 cases with thyroid nodules undergoing CNB were selected.Cytology,histopathology,and postoperative results were compared with postoperative pathology as the gold standard.Results The accuracy,sensitivity,specificity,positive predictive value,negative predictive value,false positive rate,false negative rate of FNA and CNB were 91.5％ vs 87.9％,93.2％ vs 87.5％,87.0％ vs 88.9％,94.8％ vs 95.5％,83.3％ vs 72.7％,13.0％ vs 11.1％,6.8％ vs 12.5％,respectively.There was no significant difference between FNA and CNB (P＞0.05).Conclusion Both of FNA and CNB examination show high accuracy,sensitivity and specificity in diagnosis of benign and malignant thyroid nodules,but FNA is more economical,safe,convenient and thus has more extensive clinical application.For lymphoma or borderline tumor,CNB examination combined with immunohistochemistry is of more advantages.

The understanding of the biological behavior of breast cancer has deepened, hence, local treatments for breast cancer have changed from resection to minimally invasive surgery. For patients with early breast cancer, constructing a minimally invasive interven-tion with low systemic toxicity is a problem, especially for cases involving precancerous lesions. Intraductal therapy for breast cancer, which is performed by inserting reagents through breastfeeding openings using suitable carriers, is a promising, accurate, and minimal-ly invasive method for breast cancer prevention and treatment. The combination of intraductal therapy with new therapeutic strate-gies, such as targeted therapy, endocrine therapy, and immunotherapy, might improve the therapeutic effect. Moreover, the mecha-nisms of intraductal therapy for breast cancer incorporate nanotechnology, molecular imaging, and gene sequencing. Intraductal thera-py is based on clinical and pathologic characteristics of Chinese breast cancer patients, and such characteristics must be determined prior to clinical application. This article mainly discusses the research progress of breast intraductal intervention.

Objective To analyze the clinicopathological characteristics of patients with benign thyroid nodules(BTN) and thyroid carcinoma(TC),and explore the clinical value of fine-needle aspiration biopsy (FNAB)in diagnosis of TC.Methods A retrospective analysis was conducted on the data of 2918 cases with thyroid carcinoma,who underwent surgery in the People's Hospital of Wuhan University between January 2011 and February 2015.Results Patients aged younger than 45 years old accounted for 26.23％ and 51.26％ in BTN group and CT group,respectively,and the difference between the two groups were statistically significant (P ＜ 0.05).Male patients accounted for 16.82％ and 20.15％ in BTN group and CT group,respectively,and the difference between the two groups were statistically significant (P ＜ 0.05).Patients with family history of thyroid related diseases accounted for 2.93％ and 3.70％ in BTN group and CT group,respectively,and there was no statistically significant difference between the two groups (P ＞ 0.05).Patients with solitary lesion accounted for 40.42％ and 47.95％ in BTN group and CT group,respectively,and the difference between the two groups were statistically significant(P ＜ 0.05).Af ter the application of FNAB,the percentage of the patients diagnosed with TC was increased by 4.83％ (P ＜ 0.05),and the diameter of nodular was increased by 4 cm (P ＜ 0.01).Conclusion Patients with TC have a characteristic of earlier onset age,higher proportion of male patients and lower incidence of multifocality compared with patients with BTN.There was no statistically significant difference between the TC group with family history of thyroid related diseases and the BTN group.The application of FNAB avoids of unnecessary surgeries on some BTN patients with small pathological diameter of nodule,it is important for preoperative diagnosis of thyroid nodules.

Objective To explore the effects of Chinese herbal compound Tangbikang on the expressions of p38 MAPK of sciatic nerve and plasma TNF-α in diabetic rats. Methods Ten of the sixty male SD rats were selected randomly as normal group, and the rest were fed with high-fat diet and low-dosage STZ was used to induce type Ⅱdiabetic rat models. Model rats were randomly divided into model group, mecobalamine group and Tangbikang low-, medium-, and high-dosage groups, 10 rats in each group. Each medication group was intervened with relevant medicine. Rat unilaterals sciatic nerves were taken after 16 weeks. The content of TNF-α in plasma was determined by radioimmunoassay. Western blot method was used to detect the expressions of p38 and p-p38 MAPK protein of sciatic nerve. Results Compared with normal group, the expressions of p38 and p-p38 protein and content of TNF-αin model group significantly increase (P<0.05, P<0.01). Compared with the model group, the expressions of p-p38 protein and the content of TNF-α significantly decreased after medicine intervention in different doses Tangbikang groups and mecobalamin group (P<0.05, P<0.01). The expression of p38 protein in Tangbikang high-dose group significantly decreased (P<0.05), with statistical significance (P<0.05). Conclusion Tangbikang can reduce the expression of p38 and p-p38 MAPK protein of the rat sciatic nerve, and reduce the content of TNF-α protein in rat plasma, which may be one of the effective targets of neuroprotection and abirritation of diabetic peripheral neuropathy.