Breast cancer is the most common malignant tumor in women. The key to the prognosis of breast cancer lies in early diagnosis and early treatment.At present, the early diagnosis of breast cancer mainly relies on imaging methods, and there has been a lack of clinical methods for early diagnosis of it.Exosome are small molecules selectively released from breast cancer cells to the peripheral circulation for a certain period of time. miRNA contained in them are short, non-coding regulatory RNA, which can bind to the 3′UTR region of target genes and regulate the post-transcriptional expression of target genes. Exogenous miRNA can affect the development of breast cancer, It can provide a variety of information indicating the presence of breast cancer cells, clinical staging, molecular typing and other information, which may be put into clinical application in the future as an ideal marker for the early diagnosis of breast cancer.This article reviews the research and application of exogenous miRNA in early diagnosis of breast cancer.

Objective To investigate the prevalence of BRCA1/2 mutations in breast cancer patients of Han ethnic group in southcrn China,and to provide the genetic basis for early diagnosis and treatment of breast cancer.Methods 70 samples of breast cancer patients of Han ethnic group in southern China and 70 normal control samples were tested.The whole coding exons of BRCA1 and BRCA2 genes were analyzed using hybridization based enrichment and next-generation sequencing (NGS).According to the results of NGS,we detected pathogenic mutations of BRCA genes.Results In 70 breast cancer patients,a total of 5 deleterious mutations were identified,4 of these were novel mutations,and no pathogenic variation was found in normal control group.Furthermore,we detected 3 low frequency mutations which are likely to relate to cancer susceptibility.Conclusions 4 novel deleterious mutations were reported,as well as some variants of unknown clinical significance for the prevalence of BRCA1/2 mutations of 70 breast cancer patients of Han ethnic group in southern China.

To report a case of retinoic acid syndrome due to tretinoin in the treatment of psoriasis.A 32-year-old male patient presented with psoriasis vulgaris for more than 10 years.In recent 10 years,he experienced erythema,plaques covered with multi-layered scales on the scalp,trunk,extremities accompanied by pruritus.The patient was diagnosed as psoriasis and given long-term treatment with oral vitamins,traditional Chinese medicine,and topical drugs,which resulted in a status of remission and exacerbation.Half a year prior to the presentation,the patient was given acitretin 10 mg twice daily due to the exacerbation of condition;20 days later,the dose increased to thrice daily;after another 30 days,the lesions were improved,and the frequency decreased to twice daily again;finally,a disappearance of the lesions was achieved after half a year of maintenance treatment with acitretin 10 mg twice daily.One week prior to the presentation,the treatment strategy was altered from acitretin to viaminate 50 mg twice daily;after three days with viaminate,the patient experienced a sudden worsening of psoriatic lesions with an obvious inflammatory reaction;subsequently,the lesions rapidly spread to the whole body surface and fused into large patches,accompanied with the following signs:marked edema,massive desquamating,high fever (＞39℃),hypotension,respiratory distress,pulmonary edema,pleural and pericardial effusions,renal dysfunction,peripheral blood leukocytosis.The patient was diagnosed as retinoic acid syndrome(RAS).After given oral glucocorticoid,symptomatic and supportive treatment,he experienced a relief of symptoms.These findings indicate that RAS is an entity with an abrupt onset and poor prognosis.For patients with RAS,early diagnosis and prompt management with corticosteroids,symptomatic and supportive treatments are essential to avoid potential fatal complications.

Objective To analyze the histological underestimation of stereotactic core needle biopsy (SNCB).and tO attract clinicians' attention.Methods SNCB was performed in 146 patients with 179 lesions from September 2000 to June 2005.and 21 lesions were underestimated histologically.0f 21 nonpalpable breast lesions(NPBL).6 lesions were diagnosed as BI-RADS nl,12 8S BI-RADS Ⅳ,3 as BI-RADS V according to BI-RADS before biopsy.Mammography showed 16 lesions with calicification, 2 cases with masses,1 case with asymmetry density and 2 cases with stellate sign.Results Eleven lesions diagnosed as fibrocystic disease with atypical ductal hyperplasia by biopsy were proved to be ductal carcinoma in situ (DCIS)in 7 lesions and early infiltration in 4 lesions by pathology.3 lesions diagnosed as severe atypical hyperplasia by biopsy were finally proved to be 1 carcinoma in situ and early infiltration in 2 lesions by pathology.3 lesions diagnosed as DCIS by biopsy were invasive carcinoma.4 lesions diagnosed papillary lesions by biopsy and finally were 1 carcinoma in situ,1 early infiltration,1 infiltrating ductal carcinoma and l intraductal papillary adenocarcinoma.Conclusion The histological underestimation of SCNB Was related to the stereotactic location technology,lesion and doctor'S understanding,the radiologist should master the biopsy skills.

The whole length of exon 11 of BRCA1 was sequenced (total 3427 bp) in 59 patients and 10 healthy female blood donors. To allow a rapid determination of the different BRCA1 alleles, a sequence-specific primer PCR method (PCR-SSP) was established and was applied to 57 additional female donors. Finally, the full-length coding region of BRCA1 was analyzed through reversed-transcriptase PCR (RT-PCR) and cDNA sequencing (total 5554 bp) in one donor with wild-type allele and 2 patients with one or two mutated alleles. By genomic DNA sequencing, 5 homozygous polymorphisms were observed in 18 patients: 2201C＞T, 2430T＞C, 2731C＞T, 3232A＞G and 3667A＞G. All of them were previously observed in Caucasians, Malay and Chinese, but for the first time the mutations were found in one allele (GenBank AY304547). Twenty-six patients and 4donors were heterozygous at these 5 nucleotide positions. The remaining 15 patients and 6 donors showed a sequence identical with the standard BRCA1 gene. Combined the PCR-SSP results and in a summary, 6 of 67 (9.0 %) healthy individuals were homozygous for the mutated allele, whereas 18 of 59 (30.5 %) breast cancer patients were homozygous. A Chi-square test showed a significant correlation between homozygous mutated BRCA1 allele and breast cancer. The cDNA sequencing showed that 2 additional mutations, 4427T＞C in exon 13 and 4956A＞G in exon 16, were found. A new BRCA1 allele, which is BRCA1-2201T/2430C/2731T/3232G/3667G/4427C/4956G (GenBank AY751490), was found in Chinese. And the homozygote of this mutated allele may implicate a disease-association in Chinese.

The whole length of exon 11 of BRCA1 was sequenced (total 3427 bp) in 59 patients and 10 healthy female blood donors. To allow a rapid determination of the different BRCA1 alleles, a sequence-specific primer PCR method (PCR-SSP) was established and was applied to 57 additional female donors. Finally, the full-length coding region of BRCA1 was analyzed through reversed-transcriptase PCR (RT-PCR) and cDNA sequencing (total 5554 bp) in one donor with wild-type allele and 2 patients with one or two mutated alleles. By genomic DNA sequencing, 5 homozygous polymorphisms were observed in 18 patients: 2201C>T, 2430T>C, 2731C>T, 3232A>G and 3667A>G All of them were previously observed in Caucasians, Malay and Chinese, but for the first time the mutations were found in one allele (GenBank AY304547). Twenty-six patients and 4 donors were heterozygous at these 5 nucleotide positions. The remaining 15 patients and 6 donors showed a sequence identical with the standard BRCA1 gene. Combined the PCR-SSP results and in a summary, 6 of 67 (9.0 %) healthy individuals were homozygous for the mutated allele, whereas 18 of 59 (30.5 %) breast cancer patients were homozygous. A Chi-square test showed a significant correlation between homozygous mutated BRCA1 allele and breast cancer. The cDNA sequencing showed that 2 additional mutations, 4427T>C in exon 13 and 4956A>G in exon 16, were found. A new BRCA1 allele, which is BRCAI-2201T/2430C/2731T/3232G/3667G/4427C/4956G (GenBank AY751490), was found in Chinese. And the homozygote of this mutated allele may implicate a disease-association in Chinese.

0.05),but decrease of BP in groupⅠandⅡhad conspicuous difference compared with groupⅢ(P

To study the mechanism of Condyloma acuminatum (CA) recurrence, and the association of CA recurrence with the ability of the host derived lymphoblastoid cell lines (LCL) stimulated by LPS to produce tumor necrosis factor (TNF), EBV-transformed B LCL were used as TNF producing cells. The ability of LCL stimulated by LPS to produce TNF was measured by bioassay. The results showed that the LCL from CA patients (including recurrent and non-recurrent CA patients) produced similar level of TNF stimulated by LPS to that of normal controls (29.54% +/- 11.28% vs 34.31% +/- 11.46%, P = 0.1498). The LCL of CA recurrent patients produced significantly lower amount of TNF than that of non-recurrent CA patients (23.72% +/- 7.41% vs 37.33% +/- 11.10%, P = 0.0032). Compared with the normal controls, CA recurrent patients showed a decreased ability to produce TNF (23.72% +/- 7.41 vs 34.31% +/- 11.46, P = 0.0054), whereas CA non recurrent patients had the similar ability to the controls (37.33% +/- 11.10 vs 34.31% +/- 11.46, P = 0.4914). It was concluded that the onset of CA was not relevant to the individual's ability to produce TNF. But the recurrence of CA was associated with the ability to produce TNF. It was also indicated that the TNF involved cellular immunity might play an important role in the clearance of the residual HPV by the host after treatment.
Adolescent ; Adult ; B-Lymphocytes ; immunology ; metabolism ; pathology ; Cell Line ; Condylomata Acuminata ; immunology ; pathology ; Female ; Humans ; Lipopolysaccharides ; pharmacology ; Lymphocyte Activation ; immunology ; Male ; Middle Aged ; Recurrence ; Tumor Necrosis Factor-alpha ; biosynthesis ; genetics

Objective To investigate the correlation between the relapse of condyloma acuminatum(CA)and the potential capability of tumor necrotic factor (TNF) production of the host′s peripheral blood leukocytes. Methods Forty-two CA patients and 58 normal controls were enrolled in this study. CA relapse was diagnosed clinically. EB virus-transformed B lymphoblastoid cell line(LCL)were used as TNF producing cells. The TNF producing capability of LCL was measured by bioassay using L929 (a TNF sensitive tumor cell line) as target cells. The LCL were stimulated with LPS to produce TNF. Results The average level of TNF production of LCL from all CA patients (including recurrent and non-recurrent CA patients) was similar to that of normal controls (30.14% ? 12.27 vs 34.06% ? 12.06,P = 0.1136). However, the level of TNF production of LCs from recurrent CA patients was significantly less than that from non-recurrent CA patients (24.75% ? 7.51 vs 36.62% ? 10.96,P = 0.00016). Compared with that of normal controls, recurrent CA patients showed a lower capability to produce TNF (24.75% ? 7.51 vs 34.06% ? 12.06,P = 0.00054), whereas non-recurrent CA patients showed a similar capability to normal controls (36.62% ? 10.96 vs 34.06% ? 12.06,P = 0.3517). Conclusions These results indicate that the cellular immune mechanism might play an important role in the clearance of the residual HPV from the host, in which TNF is involved.

Objective To evaluate the value of sterotactic mammorgraphy core needle biopsy in the diagnosis of nonpalable breast lesion. Methods 32 cases in this study were diagnosed by SMCNB,of whem,21 cases were operated on.Pathologic findigs of the tissues through SMCNB were compared with those of tissues by operation. Results Accuracy of diagnosis from SMCNB was 95%,sensitivity 80%,and specificity 100%.False negative result was found in 1 case.No false positive result occurred. Conclusions SMCNB is a simple and less invasive procedure with accurate location.It is valuable in the diagnosis of nonpalpable breast lesions.