PDF file, 38K, Supplementary Figure 2: Serum levels of TPS, CEA, CA125 and CA15-3 in breast benign diseases (BD) compared with that of in breast cancer (BC).

Implant-based breast augmentation remains popular, but the controversy over the safety and longevity of implants has continued. An event-based analysis of reasons for implant explantation may provide us with some insight into the controversy. Data from May 1994 to October 2022 of explantation cases from aesthetic breast augmentation in three medical centers were retrospectively reviewed. Patient characteristics, time to explantation, reasons for visit, the major reason for explantation and intraoperative findings were analyzed. A total of 522 patients with 1004 breasts were included in our study. Objective explantation reasons accounted for 34.0 www.springer.com/00266 .

PDF file, 54K, Supplementary Figure 1: SDS-PAGE and western blotting of SOX2.

目的 探讨Rh血型系统RHD基因表达相关微小RNA(miRNA),及其在干预RHD基因表达中的作用.方法 利用生物信息学软件TargetScan、PicTar和miRWalk预测靶向作用于RHD基因的miRNA,综合3个数据库的结果选取靶标率最高的5个miRNA进行研究.聚合酶链反应(PCR)扩增RHD基因3'-非编码区(3'-UTR)序列,插入到双酶切的双荧光素酶报告基因载体中,将报告基因载体与miRNA共转染细胞,通过相对荧光素酶活性分析测定miRNA对RHD基因的靶向作用.采用实时荧光定量PCR检测miRNA在RhD阳性及"弱D"表型样本中的表达.结果 成功构建RHD基因3'-UTR双荧光素酶报告基因载体.该报告基因载体与miRNA-566、miR-1183和miR-1207共转染细胞的相对荧光素酶活性与对照比较分别下降了37％(P<0.05)、13％(P<0.05)和14％(P<0.05),提示miRNA-566、miR-1183和miR-1207潜在靶向调控RHD基因.miRNA-566和miR-1183在"弱D"表型样本中的相对表达量显著高于RhD阳性样本(P<0.05).结论 RHD基因3'-UTR双荧光素酶基因报告载体构建成功.miR-566和miR-1183对RHD基因有靶向抑制作用.

The safety of banked human adipose-derived stem cells (hADSCs) purified by 155 mM ammonium chloride (NH4Cl)-based erythrocyte lysis has not been evaluated. This study was conducted to determine the impact of NH4Cl-based erythrocyte lysis on the biological characteristics of cryopreserved hADSCs. Stromal vascular fractions (SVFs) were obtained from lipoaspirates and purified with NH4Cl-based erythrocyte lysis (lysis group) or without (nonlysis group). The hADSCs were freshly isolated (fresh group) from SVFs and/or cryopreserved for 2 weeks (cryo group). The morphologies, immunophenotypes, viability, apoptosis, and growth kinetics of each group were compared. The cell cycle and differentiation capacity assays were performed in both cryopreserved groups. All groups showed similar cell morphology, immunological phenotypes, and viability. However, the main effect of lysis and its interaction with cryopreservation were observed when early apoptosis was regarded as a dependent variable in two-way repeated-measures analysis of variance. After cryopreservation, significant growth retardation and S-phase fraction reduction were observed in lytic hADSCs compared with those in nonlytic hADSCs. No significant differences in the adipogenic and osteogenic differentiation capacities were found between the two groups. Although NH4Cl-based erythrocyte lysis did not affect the cell morphology, immunological phenotypes, viability, and adipogenic and osteogenic differentiation capacities of cryopreserved hADSCs, exposure to NH4Cl-based erythrocyte lysis or its synergistic action with cryopreservation may induce apoptosis and inhibit the proliferation and mitosis of cryopreserved hADSCs. These results indicate that NH4Cl-based erythrocyte lysis is not suitable for high-quality banked collection of hADSCs for future clinical applications. Further development of safe, convenient, and cost-effective purification methods of hADSCs is warranted.

探讨检验科与临床科室之间如何建立有效的沟通方式,以便为临床诊疗提供更好的服务.检验与临床沟通可随时随地进行,并贯穿检验流程的全过程.检验与临床沟通渠道通畅,会助力检验医学发展,从而更快、更好地为临床服务.

目的 分析肿瘤患者分离的耐碳青霉烯类肠杆菌目细菌耐药基因携带及耐药性特点,为临床治疗及感染防控提供参考.方法 对2018年5月1日-2021年6月30日中国医学科学院肿瘤医院深圳医院耐碳青霉烯类肠杆菌目细菌进行筛选,鉴定和药敏采用VITEK-2 Compact系统进行,采用全基因测序技术检测相关菌株的碳青霉烯类耐药基因、超广谱β-内酰胺酶(ESBLs)、AmpCβ-内酰胺酶(AmpC酶)等耐药基因型别,并分析药敏结果.结果 共收集耐碳青霉烯类肠杆菌目细菌15株,经全基因组测序检测发现13株菌携带的碳青霉烯酶基因主要为blaNDM-5基因(6株)、blaNDM-1基因(3株)、blaOXA-1基因(3株),blaKPC-2基因(1株)、blaSME-4基因(1株)、blaOXA-10基因(1株).有3株菌均未检出碳青霉烯酶基因,12株菌均存在OmpK36膜孔蛋白基因缺失,有4株菌同时出现OmnpK36和OmpK35膜孔蛋白基因缺失,15株菌株均检出ESBLs基因或AmpC酶等相关耐药基因.15株菌对碳青霉烯类、氨曲南、青霉素类、头孢菌素类、青霉素/青霉素酶抑制剂、氟喹诺酮类等抗菌活性物质显示出较高的抗性,而对替加环素和阿米卡星有较好的敏感性.结论 医院肿瘤患者耐碳青霉烯类肠杆菌目细菌耐药机制主要以产B类金属β-内酰胺酶NDM基因型同时合并ESBLs基因或AmpC酶等相关耐药基因及合并OmpK36膜孔蛋白基因缺失为主,并呈现多药耐药的特点.

BACKGROUND:External volume expander (EVE)-assisted autologous fat grafting is suitable for breast augmentation, but no large sample study in Asia has confirmed this method. OBJECTIVES:The authors reported their experience and outcomes in augmentation mammoplasty with EVE-assisted autologous fat grafting. METHODS:A retrospective study was conducted in 305 female patients who underwent augmentation mammoplasty with EVE-assisted fat grafting between September 2012 and December 2020. Doctors utilized Crisalix (Crisalix S.A., Lausanne, Switzerland) for 3-dimensional (3D) imaging acquisition to measure the increase in breast volume to evaluate doctor satisfaction. The Preoperative Satisfaction with Breast and BREAST-Q questionnaires were employed to assess patients' preoperative and postoperative satisfaction, respectively. RESULTS:The 305 female patients were aged 18 to 50 years (mean, 35.9 years). Among them, 68.52% were "very satisfied," 18.69% were "somewhat satisfied," 11.15% were "somewhat dissatisfied," and 1.64% were "very dissatisfied" based on BREAST-Q analysis, whereas 100% were dissatisfied according to the Preoperative Satisfaction with Breast questionnaire. Doctors employed Crisalix to measure the increase in breast volume to evaluate doctor satisfaction. The results showed 76.01% had an increase in breast volume of 150 to 250 mL or >250 mL and were "satisfied" and "very satisfied," respectively, 21.64% had an increase of 50 to 149 mL and were "somewhat satisfied," and 2.30% had an increase <50 mL and were "dissatisfied." There were no complications, such as obvious fat liquefaction, infection, or fat embolism. CONCLUSIONS:Augmentation mammoplasty with EVE-assisted fat grafting is effective and satisfying in China. Crisalix for 3D imaging acquisition is convenient and effective in measuring breast volume. LEVEL OF EVIDENCE: 4:

目的 通过对原国家卫生和计划生育委员会下发的15项临床检验专业医疗质量控制(简称质控)指标的监测、分析,探讨如何合理利用15项质控指标来提高检验质量.方法 收集中国医学科学院北京协和医学院肿瘤医院深圳医院检验科2020年1—12月的相关数据,统计分析标本类型错误率、血培养污染率、危急值通报率等15项医疗质控指标的监测结果.结果 全年质控指标监测显示,控制较满意的指标有室内质控项目开展率、室间质评项目参加率、危急值通报率等6项,控制较稳定的有标本类型错误率、标本容器错误率、检验前周转时间等6项,控制不满意但持续改进有所成效的指标有血培养污染率、室内质控项目变异系数不合格率和检验报告错误率3项.结论 通过对15项医疗质控指标的监测,可实现对检验全过程的质量管理,以便及时发现问题,及时提出改进措施,并监控改进效果,达到持续改进目的,从而更快、更好地为临床服务.

Background and Aims Esophageal squamous cell cancer (ESCC) is one of the leading malignant cancers with a high incidence and mortality. Exploring novel serum biomarkers will help improve the management and monitoring of ESCC. Methods In the present study, we first used a ProcartaPlex Array to screen for serum proteins that were increased in 40 ESCC patients compared with matched normal controls; we found that eight proteins (IL-2, IL-5, IP-10, IL-8, eotaxin, TNF-alpha, HGF, and MIP-1b) had higher serum levels in ESCC patients than in normal controls. We further verified the clinical relevance of the candidate biomarkers with a larger sample of sera. Results In the 174 tested ESCC patients and 189 normal controls, the serum levels of eotaxin and IP-10 were significantly higher in patients than in normal controls (p = 0.0038, 0.0031). In particular, these two proteins were also elevated in the sera of patients with early-stage (0-IIA) ESCC (p = 0.0041, 0.0412). When combining CEA and CYFRA21-1 (in use clinically) with eotaxin or IP-10, the effectiveness of detecting ESCC was superior to that of CEA and/or CYFRA21-1 alone. Moreover, the serum level of eotaxin dropped significantly after surgical resection of primary tumors compared with that in preoperative ESCC samples (p < 0.001). Conclusions The data suggest that serum eotaxin and IP-10 might be potential biomarkers for the detection of ESCC.

背景:脂肪干细胞的提取及纯化流程尚未建立统一标准.最常用的纯化脂肪干细胞的方法是利用红细胞裂解液处理基质血管成分.但这一步骤是否对脂肪干细胞存在不良影响仍缺乏证据,是否有利于未来临床应用仍有待探讨.目的:比较氯化铵红细胞裂解液法和非裂解法提取脂肪干细胞的效率,并进一步比较两种方法提取脂肪干细胞的生物学特性.方法:收集吸脂手术患者脂肪组织,经Ⅰ型胶原酶消化后,利用或不用氯化铵红细胞裂解液对基质血管成分进行纯化,MuseTM细胞状态分析仪对活细胞计数及活细胞比例评估;将基质血管成分接种后培养人脂肪干细胞至第2代,光学显微镜观察脂肪干细胞形态,流式细胞学分析脂肪干细胞表型,CCK-8法绘制细胞增殖曲线,成脂及成骨培养基诱导后油红O及茜素红染色法分别评估成脂、成骨分化能力.该实验经中国医学科学院整形外科医院伦理委员会批准,并与患者签署相关知情同意书.结果与结论:①与裂解组相比,非裂解组提取即刻的基质血管成分中非红活细胞数更多,活细胞百分比更大;②两组脂肪干细胞均呈梭形、鱼群状排列;③两组细胞均高表达CD90、CD73、CD105等细胞表面抗原,低表达或不表达CD11b、CD34、CD19、CD45、HLA-DR等细胞表面抗原;④非裂解组细胞增殖速度更快,成脂及成骨能力两组间无明显区别;⑤结果表明,利用氯化铵红细胞裂解液法提取基质血管成分降低了脂肪干细胞提取效率,抑制了脂肪干细胞增殖能力.非裂解过程不影响脂肪干细胞表型及成脂、成骨分化能力.因此不建议在人脂肪干细胞提取过程中进行氯化铵法红细胞裂解.

BACKGROUND:Endoscopic transaxillary augmentation mammaplasty breast augmentation offers several advantages over other augmentation methods. Nonetheless, this procedure is fraught with some problems, including greater surgical trauma due to the longer separation area. We hypothesized that cold separation of the interpectoral space could reduce surgical injury in comparison to the electrosurgical method. This study aimed to compare the outcomes of endoscopic-assisted transaxillary augmentation mammaplasty using cold separation versus electrosurgical separation of the interpectoral space. METHODS:In this prospective clinical trial, cold and electrosurgical separation of the interpectoral space were achieved using a separation shovel and monopolar electrotome, respectively. A total of 20 patients who visited our department in Beijing, China, for primary breast augmentation surgeries from October 1, 2017, and May 31, 2018, were included. The primary outcome was total postoperative drainage volume. The secondary outcomes were operative time, daily drainage volume, daily pain as assessed using the visual analogue scale (VAS), and reoperation rate. Quantitative data were compared using independent-samples t test. Chi-square test was used to compare 2 classified indexes. RESULTS:The total drainage volume was significantly lower in the cold separation group than in the electrosurgical separation group (170.45 ± 75.40 mL vs 281.05 ± 148.43 mL; P = .005). The VAS score on the first postoperative day was significantly lower in the cold separation group than in the electrosurgical separation group (6.45 ± 1.93 vs 7.55 ± 1.43; P = .048). Two (20%) reoperations owing to postoperative pain or implant stiffness were performed in the electrosurgical separation group. CONCLUSIONS:Cold separation is more conducive to reducing drainage, relieving postoperative pain, and causing less damage than the electrosurgical method in endoscopic-assisted transaxillary dual-plane augmentation mammaplasty.

We aimed to verify the expression status and diagnostic significance of isocitrate dehydrogenase 1 (IDH1) in non-small-cell lung cancer (NSCLC), especially during early stages. Serum IDH1 levels were measured by ELISA. A total of 1223 participants (660 patients with NSCLC, 276 healthy controls [HCs], 95 patients with benign pulmonary conditions [BPCs], 135 patients with other cancers [OCs], and 57 samples with interfering factors) were divided into a training cohort and a validation cohort according to 3 testing centers. The IDH1 concentrations in the NSCLC group were obviously higher than those in the control groups (P < .001). Area under the receiver operating characteristic curves (AUCs) for discriminating NSCLC patients from controls (HC, BPC, and OC) were 0.870 and 0.745 (sensitivity, 63.3% and 55.0%; specificity, 86.8% and 86.3%) in the training cohort and validation cohort, respectively. The AUCs for discriminating stage 0-IA lung cancer patients from HCs were 0.907 and 0.788 (sensitivity, 58.6% and 59.1%; specificity, 92.9% and 89.3%) in 2 cohorts, respectively. Isocitrate dehydrogenase 1 showed specificity for NSCLC and had no diagnostic value for other common cancers. Furthermore, IDH1 was significantly reduced in postoperative serum. Isocitrate dehydrogenase 1 shows clinical utility as a serum protein biomarker for the early diagnosis of NSCLC.

目的 对化学发光免疫分析法检测甲状腺功能五项的性能进行验证,以评估检测系统检测甲状腺功能五项的准确性和稳定性.方法 采用迈瑞CL6000i全自动化学发光免疫分析仪,依照美国临床和实验室标准协会标准,对分析仪检测数据的精密度、正确度、线性、生物参考区间、最低检出限、携带污染进行验证和评价.结果 游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)的批内精密度均小于1/4 TEa(CLIA'88),批间精密度小于1/3 TEa(CLIA'88).正确度的能力验证实验成绩为100％.线性验证显示,T3、T4、TSH的相关系数≥0.990,斜率为0.95～1.05,线性良好,线性范围与厂商声明参数相符;20例健康者检测值100％在生物参考区间内.最低检出限、携带污染均小于厂商声明参数.结论 FT3、FT4、T3、T4、TSH性能验证数据均与厂商声明性能一致,符合CLIA'88和ISO15189实验室认可标准的要求.迈瑞CL6000i全自动化学发光免疫分析仪检测甲状腺功能五项的稳定性好,准确性高,能够满足临床检验的需求.

2019年12月,武汉市首次发现多起新型冠状病毒肺炎(COVID-19)病例,目前COVID-19已成全球蔓延趋势.COVID-19具有极强的传染性及较高的病死率,快速、准确的实验室检测对其诊疗至关重要.但COVID-19患者的临床样本具有潜在致病性和高传染性,为降低实验室人员感染风险,文章就新型冠状病毒(SARS-CoV-2)的病原学特点、实验室检测及生物安全防护相关措施作一综述.

检验全程质量管理包括分析前、分析中和分析后质量管理,而标本运输是分析前质量管理的重要环节.该文分析了当前检验标本送输的4种方式,并通过对标本运输方式优缺点比较,分析了各种运输方式的特点及适用范围.建议医院选择适合我国国情和医院实际的物流传输系统,提高工作效率,降低综合成本,提升医院竞争力,同时提高医院整体运营效益.

Nodules or calcifications have been a common complication after breast augmentation with fat grafting, especially in cases with partial bolus fat grafting. There are some clinical preventive measures, but mechanisms related to this complication have not been elucidated yet. Inorganic phosphate (PI), being a product of fat metabolism, is a well-known stimulus of other kinds of pathological calcification such as vascular calcification. We aimed to determine whether PI had a similar effect on formation of nodules after fat grafting. Nodules or calcification after fat grafting models using nude mice were created by bolus fat injection. Levels of PI of necrotic liquid located in the central zone and mineralization deposition of graft were examined 1 week, 2 weeks, 1 month, 2 months and 7 months after bolus fat injection. External high phosphate solution was injected 3 times a week to the fat grafts for 2 months, and mineral deposition was examined. In addition, adipose-derived stem cells (ADSCs) were treated with high phosphate osteogenic differentiation medium in various concentrations and times. ADSCs were also treated with osteogenic differentiation in addition to tetramisole which could reduce the level of PI. Mineral depositions of the cells were examined. The central necrotic liquid was extracted from patients who found palpable nodules after breast augmentation with fat grafting. The level of PI of this necrotic liquid and normal lipoaspirates from patients who received normal liposuction for body contouring was compared. The in vivo study indicated that the local PI concentration of the necrotic zone increased significantly 2 months after large volume bolus fat injection. Calcification was not formed after 2 months, but was formed after 7 months, indicating that the effect of PI on calcification was time-dependent. In addition, with the effect of external injection of high phosphate solution into the fat graft, calcification was formed after 2 months, indicating the effect of PI on calcification was dose-dependent. The in vitro study also indicated PI could induce calcification of ADSC in a time- and dose-dependent manner. The study in humans indicated that the level of PI in the necrotic zone of nodules after fat grafting was higher than that in normal lipoaspirates. This study indicated that the level of PI in the central necrotic zone was elevated after bolus fat injection, which could provide an environment to induce calcification of surrounding tissue. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

目的 探讨患者全血作为红细胞沉降率(ESR)室内质控品的可行性.方法 收集日常工作中无传染性的剩余全血,自制ESR高值、低值室内质控品,每天随日常标本一同在VACUETTE Sad Rate Timer 20 ESR仪上进行检测,对其精密度及稳定性等参数进行分析.结果 VACUETTE Sad Rate Timer 20 ESR仪显示,自制质控品水平1的批内精密度和日间精密度分别为3.22％ 和3.42％;水平2的批内精密度和日间精密度分别为2.29％ 和2.61％.在稳定性方面,自制质控品10个月内各时间点测定值差异无统计学意义(P>0.05).结论 自制质控品具有制备过程简便、稳定性好、成本低等优点,可以满足室内质量控制的要求.

BACKGROUNDThe current study aims to evaluate whether serum IGF2AS can be used as a marker for early diagnosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).METHODSFirst, the expression of IGF2AS in serum and cancer tissues of HBV-related HCC patients was detected using RT-PCR. Then, according to the Barcelona Staging Method (BCLC), HBV-related HCC patients were further divided into group A, B, C, and D. The serum IGF2AS levels of different groups were further detected. Additionally, HBV-related HCC patients were divided into alpha-fetoprotein (AFP) negative cases and AFP positive cases. The serum level of IGF2AS was also evaluated.RESULTSOur data showed that the level of IGF2AS in liver cancer tissues of HBV-related HCC was significantly higher than that in the adjacent non-cancerous tissues. Meanwhile, the serum level of IGF2AS in the HBV-related HCC group was higher than that in healthy control group, chronic HBV group, and HBV-related cirrhosis. Moreover, serum IGF2AS in patients with HBV-related HCC gradually increased in groups A, B, C, and D of HBV-re-lated HCC patients according to BCLC classification. Further analysis showed that serum IGF2AS levels were increased in both AFP-negative HCC patients and AFP-positive HCC patients compared to that in HBV-related cirrhosis patients, suggesting that serum IGF2AS can be used in early identification and diagnosis of HBV-related HCC irrespective of AFP levels.CONCLUSIONSIn summary, for the first time, the current study demonstrated that serum IGF2AS may be a potential biomarker for the diagnosis of HBV-related HCC.