[摘 要] 目的：用组织代谢组学方法，探讨甲状腺乳头状癌（papillary thyroid carcinoma, PTC）组织及癌旁组织的代谢差异，寻找PTC的潜在生物标志物，探索PTC的发病机制与治疗策略。方法：收集2018年10月至2020年2月期间湖南省人民医院乳甲外科手术切除的40例PTC患者的癌组织及癌旁组织标本。利用HPLC-MS技术平台对PTC组织及癌旁组织样本的差异性代谢物进行多维统计分析，寻找与PTC相关的异常代谢通路。结果：经PCA、PLS-DA、OPLS-DA分析得知癌组织和癌旁组织的代谢轮廓具有显著性差异。经OPLS-Loading plot分析，结合VIP>1、FC>2，且P<0.05，筛选出76个潜在差异性代谢物。其中亮氨酸、2-褪黑素、香草酸等33种代谢物在PTC组织中表达上调；3-葡萄糖苷、甘油磷脂、磷脂酰胆碱、乳糖等43代谢物在PTC癌组织中表达下调。寻找到与差异性代谢物相关的13条异常代谢通路，如半胱氨酸与蛋氨酸代谢、与甘油磷脂代谢、嘧啶代谢、半乳糖代谢以及丙氨酸、天冬氨酸和谷氨酸代谢、柠檬酸循环等，这些代谢通路可能参与PTC代谢的病理生理过程。ROC曲线下面积大于0.9的差异性代谢物有5种，分别是庚二酸、糖醇、辛二酸、乳糖和L-丝氨酸。结论：PTC组织中半乳糖代谢和氨基酸代谢发生改变，PTC组织细胞中存在沃伯格效应(Warburg effect)。庚二酸、糖醇、辛二酸、乳糖、L-丝氨酸五种差异性代谢物可以用来区分PTC患者与正常人。

To study the clinical and pathological characteristics and prognostic factors of primary breast diffuse large B-cell lymphoma (PBDLBCL). Methods: Clinical and pathological data of 62 patients with PBDLBCL from January 2006 to December 2016 were retrospectively analyzed. The Kaplan-Meier method was used for univariate analysis and the Cox regression model for multivari-ate analysis. Results: The 62 patients analyzed included women aged 26-71 years, with a median age of 47 years. Patients were fol-lowed up from 6 to 105 months; the 3-year overall survival (OS) rate was 71.0%, and 5-year OS rate was 51.0%. The univariate analysis showed statistically significant differences in the clinical stage, lactic acid dehydrogenase level, International Prognostic Index score, Myc/Bcl-2 protein expression, and chemotherapy regimen at 3 and 5 years associated with OS rates. The multivariate analysis showed that Myc/Bcl-2 protein expression was an independent prognostic factor of OS. Conclusions: Comprehensive treatment with chemo-therapy and radiotherapy is appropriate for PBDLBCL. Myc/Bcl-2 protein expression is an independent adverse prognostic factor for PB-DLBCL.

Objective To analyze the research status quo of the five elements music in Chinese Traditional Medicine, so as to provide reference for clinical practice. Methods A self-designed article information extraction form was applied. A total of 90 papers on the topic of five elements music in Chinese Traditional Medicine which met the inclusion criteria from CNKI and Wanfang Medical Database Articles from January 1997 to January 2017 were analyzed. Results Since 2011, the number of papers about the five elements music in Chinese Traditional Medicine had been gradually increasing 37.8% of the papers were supported by scientific research funds; 26.7% of the papers were multi center cooperative research; 95.2% of the intervention studies set the control group; 25.3% were used in cancer patients; and 100% of the intervention effects were effective. Conclusions The five elements music in Chinese Traditional Medicine could be widely used in treating various diseases, however, there is still room for improvement in research designe.

OBJECTIVE:To evaluate the effect of CD44 on drug resistance of breast cancer patients. METHODS:62 breast cancer patients were selected,and the expression of CD44 was detected by immunohistochemical method. Drug resistance was eval-uated by WHO criteria,and the expression of CD44 in breast tissue was observed after observation. RESULTS:There were 48 pa-tients sensitive to CD44 and 14 patients with drug resistance,with statistical significance(P<0.05). After chemotherapy,the ex-pression of CD44 in caner tissue was higher than before chemotherapy,that of patients with drug resistance was higher than pa-tients sensitive to CD44,with statistical significance(P<0.01). CONCLUSIONS:CD44 antigen is closely related to chemothera-py resistance of breast cancer,and high expression of CD44 can be used as an important indicator for breast cancer chemotherapy.