2014年 · 第94卷第12期

Research misconduct is a global problem. In 2013, Hiroaki Matsuhara, a former professor at Kyoto Prefectural Medical University in Japan, artificially manipulated and changed the news of clinical trial data in a clinical research paper on the prevention of stroke by the antihypertensive drug valsartan, and GlaxoSmithKline's experimental compound for the treatment of multiple sclerosis. The data fraud storm once again triggered extensive discussions in the medical community about scientific integrity and scientific research misconduct^[1]。 It is not an isolated incident to artificially alter the data in papers and manipulate the research results of clinical trials. In recent years, with the repeated exposure of many cases of forgery, tampering and plagiarism in the scientific community, scholars with different research qualifications in the medical field have paid widespread attention to and thought about scientific research misconduct in clinical medical research in China.

The fifteenth World Cancer Day is celebrated on February 4, 2014, and the theme of this year's Cancer Day is "Eliminating misconceptions about cancer". Globally, the following four points are the main misconceptions about cancer: (1) We don't need to talk about cancer; (2) For people who have or are about to suffer from cancer, there are no signs and signals that can predict it; (3) There is nothing we can do about cancer; (4) It is useless to use various lifestyles to prevent cancer. The World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) strongly support the International Alliance Against Cancer (UICC) to use various methods to reduce the global burden of cancer, accelerate the progress in cancer research, prevention and treatment, and benefit mankind. Preventing cancer and improving the quality of life of cancer patients are recurring themes on World Cancer Day.

An 81-year-old male patient underwent esophagography in an external hospital on August 6, 2013 due to "eating obstruction for 6 months and aggravation for 1 week". It showed that a 4 cm long oval filling defect was seen in the middle esophagus, which was considered to be cancer of the middle esophagus. On August 8th, I was admitted to the 105th Hospital of the People's Liberation Army. Chest CT showed that the local wall of the middle and lower esophagus was obviously unevenly thickened, and the local wall was mass-shaped and concave into the lumen, and the lumen of the lesion area was narrow. The initial diagnosis was middle and lower esophageal cancer. On August 12th, gastroscopy showed that the esophageal mucosa was 25-30 cm away from the incisors, which was considered esophageal cancer. Immunohistochemical results of esophageal lesions on August 19 showed: tumor cells S-100+, Melan-A +, HMB45+, 34 β E12-, 35 β H11-or +, LCA-, CD34-, CD117 partially weak +, CK5/6-, P63-, esophageal biopsy impression: malignant melanoma; There were no obvious abnormalities in blood, biochemistry, urine, fecal routine and abdominal B-ultrasound. The patient consumed alcohol occasionally and had no history of smoking. Physical examination: Multiple superficial lymph nodes were palpable in the right neck and bilateral axillaries, with the largest size of 1 cm ×1 cm; There were no obvious abnormalities in the rest. Therapeutically, three-dimensional conformal radiotherapy and interferon biological therapy were given. After 3 months of follow-up, reexamination of chest CT showed that the extent of esophageal lesion was significantly reduced, and semi-liquid was now available.

Thyroid cancer is the most common malignant tumor of endocrine system, accounting for about 1% of new human malignant tumors, and it is increasing year by year. The classic treatment regimen for papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) is total or near total thyroidectomy plus radioactive¹³¹I therapy + thyroid hormone suppression therapy, the 5-year survival rate is about 85%^[1]。 While the other 15% of patients may develop poorly differentiated thyroid cancer or even undifferentiated thyroid cancer (ATC). As a highly malignant tumor, ATC has strong invasiveness and distant metastasis ability, which makes surgery, radiotherapy and chemotherapy have no obvious effect on prolonging the survival time and improving the quality of life of patients. Poorly differentiated thyroid cancer, due to its extremely low iodine uptake capacity, like ATC, has no effective treatment once it metastasizes.

The recurrence peak of early breast cancer (stage Ⅰ ~ ⅢC) is concentrated 2~3 years after surgery (i.e., recent recurrence), but there are differences in the recurrence pattern of different molecular subtypes^[1]Luminal breast cancer is clinically positive for estrogen receptor (ER) and/or progesterone receptor (PR), accounting for about 60% to 80% of all breast cancers. A meta-analysis covering nearly 10,000 patients showed that the prognosis of early Luminal breast cancer was better than that of hormone receptor-negative patients in the first 5 years after surgery, while the prognosis of Luminal breast cancer was relatively poor 5 to 15 years after diagnosis^[2]and nearly 50% of recurrences occurred after the end of 5 years of adjuvant endocrine therapy (i.e. long-term recurrences)^[3,4]Some even appear decades after surgery, and it is of far-reaching significance to correctly understand long-term recurrence. This article will comprehensively explain the latest research progress affecting the long-term recurrence of Luminal breast cancer after adjuvant therapy.

Adaptive immune response is the main immune response of the body to intracellular or extracellular pathogens, in which CD4^＋Helper T cells (also known as Th cells) play an extremely important role. It was previously believed that initial CD4^＋Differentiation of T cells into various types of effector cells is irreversible. Recent studies have found that certain types of differentiated CD4 cells^＋T cell subset, which can transform its own cytokine secretion profile under certain conditions, is called CD4^＋Plasticity of T cells^[1]。 CD4^＋T cells are involved in the occurrence, development and outcome of bronchial asthma^＋The research progress of T cell plasticity in asthma is reviewed below.