RÉSUMÉ
AIM:To observe how total flavonoids of Pterocarya hupehensis Skan(PHSTF)affects the migra-tion and invasion of human rheumatoid fibroblast-like synoviocyte line MH7A.METHODS:The MH7A cells were divided into control group(without any treatment),low-,medium-and high-dose(6.25,12.5 and 25 mg/L,respectively)PHSTF groups,phosphatidylinositol 3-kinase(PI3K)inhibitor 740Y-P(10 μmol/L)group,and 740Y-P(10 μmol/L)+high-dose(25 mg/L)PHSTF group.The viability of the MH7A cells was determined by CCK-8 assay,while the migration and inva-sion were assessed by scratch and Transwell assays.The protein levels of matrix metalloproteinase-2(MMP-2),MMP-9,PI3K,p-PI3K,AKT and p-AKT were detected by Western blot.RESULTS:Compared with control group,the cell via-bility in PHSTF treatment groups was reduced(P<0.05),the cell wound healing area was significantly decreased(P<0.01),migratory and invasive cells in the lower chamber were significantly reduced(P<0.01),and the protein expres-sion of MMP-2 and MMP-9 and the ratios of p-PI3K/PI3K and pAKT/AKT were decreased(P<0.01).Compared with high-dose PHSTF group,the addition of PI3K/AKT pathway agonist 740Y-P significantly increased the migration and invasion ability of MH7A cells(P<0.01)and elevated the protein expression of MMP-2 and MMP-9 and the ratios of p-PI3K/PI3K and pAKT/AKT(P<0.01)under the treatment with PHSTF.CONCLUSION:Total flavonoids of Pterocarya hupehensis Skan could inhibit the migration and invasion of MH7A cells by regulating the PI3K/AKT signaling pathway.
RÉSUMÉ
AIM:To investigate the therapeutic effect of mitochondrial fission inhibitor-1(Mdivi-1)on experi-mental autoimmune encephalomyelitis(EAE)in mice,and to explore its mechanism.METHODS:The mice immunized with myelin oligodendrocyte glycoprotein peptide fragment 35-55(MOG35-55)were randomly divided into DMSO model group and Mdivi-1 intervention group.All mice were sacrificed on the 28th day after the first immunization.The demyelination was analyzed by Luxol fast blue staining.The protective mechanism of Mdivi-1 in the spinal cord tissue was investigated by immunofluorescence staining,TUNEL staining and the in vitro experiment with MO3.13 oligodendrocytes treated with staurosporine.The mitochondrial depolarization was detected by JC-1 staining,the cell injury was checked by LDH leakage,and the viability of MO3.13 oligodendrocytes was determined by MTT assay.RESULTS:Compared with DMSO model group,the demyelinating injury was alleviated and the proportion of apoptotic CC1+ oligodendrocytes in Mdivi-1 group was decreased.The cleaved caspase-3,caspase-9,cytochrome C and Bax protein expression levels in the spinal cord of Mdivi-1-treated mice was also attenuated.The in vitro MO3.13 cell experiments suggested that Mdivi-1 inhibited MO3.13 cell mitochondrial depolarization,attenuated the cell damage and increased the cell viability.CONCLUSION:Mdivi-1 pro-tects against the myelin injury in EAE mice,which may be related to the suppression of oligodendrocyte apoptosis.
RÉSUMÉ
AIM:To explore the effect of microRNA-184(miR-184)on compensatory lung growth(CLG)af-ter lobectomy in multiple primary lung cancer(MPLC)and its mechanism.METHODS:(1)Lung tissue samples(n= 16)from MPLC patients and patients with good recovery after lobectomy(CLG)were collected,and the expression of miR-184 was measured by RT-qPCR.(2)Human alveolar epithelial cells were divided into NC-mimic group,miR-184 mimic group,OE-NC group,tissue inhibitor of metalloproteinase-2(TIMP-2)overexpression(OE-TIMP-2)group,and miR-184 mimic+OE-TIMP-2 group according to the transfection(n=3).The expression of miR-184,TIMP-2 mRNA and matrix metalloproteinase-14(MMP-14)mRNA was measured by RT-qPCR,and the protein expression of TIMP-2 and MMP-14 was determined by Western blot.The proliferation of the cells was measured by CCK-8 and colony formation assays.(3)C57BL/6J mice were divided into pneumonectomy(PNX)group and PNX+miR-184 mimic group(n=5).The flexiVent system was used to measure the vital capacity and lung compliance of the mice.Lung volume was measured by water dis-placement method,and lung tissue changes were observed by HE staining.RESULTS:The expression of miR-184 was significantly higher in the patients with better recovery after lobectomy(P<0.01).Overexpression of miR-184 promoted the proliferation of human alveolar epithelial cells and the recovery of lung function in mice after PNX.In terms of mecha-nism,miR-184 showed targeted binding with TIMP-2,and overexpression of miR-184 promoted the expression of MMP-14 by inhibiting TIMP-2,thereby promoting the proliferation of human alveolar epithelial cells and the recovery of mouse lung function after PNX.CONCLUSION:miR-184 promotes CLG after PNX through the TIMP-2/MMP-14 axis.
RÉSUMÉ
El absceso de músculo psoas iliaco se considera una rare-za. Su detección ha mejorado con la utilización de imágenes como la tomografía computada o la resonancia magnética. Presentamos una revisión de casos de absceso de psoas-iliaco internados entre julio de 2015 y febrero de 2018 en un hospital de CABA, Argentina.En este periodo se diagnosticaron un paciente conside-rado de origen primario y ocho de origen secundario. Se observó predominio de colecciones asociadas a es-pondilodiscitis. El síntoma más frecuente fue la fiebre. Staphylococcus aureus fue el germen más rescatado en muestras microbiológicas. Se debe tener alto índice de sospecha de esta patología ante la presencia de fiebre, dolor lumbar y en ocasiones alteración de la marcha. El empleo de antibióticos de amplio espectro sumado a la evacuación de colecciones constituyen la estrategia más efectiva
Psoas-iliac muscle abscess is considered a rarity, the use of images such as computed tomography or magnetic reso-nance imaging has improved its detection.This study reviews cases of psoas-iliac abscess in hospi-talized patients between July 2015 and February 2018 in a hospital in CABA, Argentina.In one of the patients the origin was considered primary ,while in the other eight it was secondary. There was a pre-dominance of collections associated with spondylodiscitis. The most frequent symptom was fever. Staphylococcus au-reus was the most frequent organism obtained in microbio-logical samples. A high level of suspicion must be held in the presence of fever, lumbar pain and sometimes alteration of the gait. The use of broad spectrum antibiotics in addition to evacuation of collections is the most effective strategy.
Sujet(s)
Humains , Adulte , Adulte d'âge moyen , Sujet âgé , Infections à staphylocoques/thérapie , Muscle iliopsoas/anatomopathologie , Abcès du psoas/diagnostic , Abcès du psoas/étiologie , Abcès du psoas/thérapie , Staphylococcus aureus résistant à la méticilline , Antibactériens/usage thérapeutiqueRÉSUMÉ
Abstract Introduction: Ketamine has been used as a pain management strategy, particularly in adults. There are some clinical data about the use of Ketamine in children but there are no reports referring to its efficacy, specifically in juvenile idiopathic arthritis. Ketamine could therefore become an alternate option in the management of refractory cases. Clinical findings: This report discusses the case of a 7-year-old male patient with a history of juvenile idiopathic arthritis who was admitted to the hospital as a result of an inflammatory pain crisis associated with stiff hands and feet, pain, edema, and enthesitis, in addition to signs of bilateral sacroiliitis, stiffness impairing gait, passive and active movements, poor response to multimodal analgesia with nonsteroidal antiinflammatory drugs, steroids and weak opioids. Adequate pain control and significant improvement of the child's function was achieved after initiating ketamine infusion at analgesic doses. Conclusions: This case provides valuable information about the usefulness of ketamine as a modulator of central sensitization and inflammation that could be extrapolated to a similar population of rheumatology patients.
Resumen Introducción: La ketamina se ha empleado como estrategia analgésica sobre todo en adultos. En los niños existen algunos datos clínicos sobre su uso, sin embargo, no hay reportes que hagan referencia de su efectividad en el caso específico de dolor por artritis idiopática juvenil, dejando esta como una posible alternativa de manejo en casos refractarios. Hallazgos clínicos: El presente reporte describe, el caso de un paciente masculino de 7 años con antecedente de artritis idiopática juvenil, hospitalizado por una crisis dolorosa de tipo inflamatorio asociado a rigidez en pies y manos, con dolor, edema y entesitis y signos de sacroileítis bilateral, dificultad para la marcha y rigidez que lo limitaba para movimientos activos y pasivos, poca respuesta a la analgesia multimodal con AINES, esteroides y opioides débiles, en quien se obtuvo un adecuado control del dolor y mejoría significativa de su capacidad funcional luego de iniciar infusión de ketamina en dosis analgésicas. Conclusión: Este caso nos brinda información valiosa sobre la utilidad de la ketamina como modulador de la sensibilización central e inflamación que podría ser extrapolada a una población similar de pacientes reumatológicos.
Sujet(s)
HumainsRÉSUMÉ
AIM:To explore the role of nuclear factor-κB(NF-κB)and activator protein-1(AP-1)signaling pathway in the inhibitory effects of Agkistrodon acutivirus protein C activator(PCA)on lipopolysaccharide(LPS)-induced tissue factor(TF)expression in human umbilical vein endothelial cells(HUVECs).METHODS: The viability of the HUVECs was measured by MTT assay.The protein distribution of tumor necrosis factor-associated factor 6(TRAF6)in the cells was detected by immunohistochemical staining.The protein expression of NF-κB p65,TF,c-Fos and c-Jun was deter-mined by Western blot.The mRNA expression of TF in the HUVECs was detected by qPCR.The content of TF in the me-dium of each group was measured by ELISA.RESULTS:Compared with the control group,the viability of the HUVECs in LPS group decreased significantly(P<0.01), obvious yellow dye particles appeared in the cytoplasm, cytoplasmic stai-ning deepened,and the average absorbance of TRAF6 was increased(P<0.01).The protein expression of NF-κB p65, c-Jun and c-Fos were significantly increased(P<0.01).The expression of TF at mRNA and protein levels were signifi-cantly increased(P<0.01).Compared with the LPS group,the cell viability in PCA +LPS group was slightly increased (P<0.05),the cell morphology was normal,cytoplasmic yellow dye particles were not obvious, and the average absor-bance of TRAF6 was significantly lower than that in LPS group(P<0.01).The protein expression of NF-κB, c-Jun and c-Fos was significantly decreased(P<0.01),and the expression of TF at mRNA and protein levels were decreased(P<0.01).CONCLUSION:PCA significantly reduces the damage of HUVECs induced by LPS.The mechanism may be a-chieved by reducing the activation of TRAF 6,NF-κB and AP-1 nuclear transcription factors,thereby reducing the release of tissue factor.
RÉSUMÉ
Objective This study is designed to improve topical medication in the Department of Orthopedics in Kunming Municipal Hospital of Traditional Chinese Medicine by applying cataplasm made from the active ingredient (polyphyllin) of Paris polyphylla Smith var. yunnanensis (Franch.) Hand.-Mazz ("Dian Chonglou"in Chinese) and to study the mechanism of anti-inflammation. Methods SD male rats were randomly divided into two groups: control group and treatment group. The rats in two groups were all injected 50ul 5% sodium urate suspension into tibiotarsal joint cavity to duplicate the model of acute gouty arthritis.The rats in the control group were applied with cataplasm without polyphyllin, whereas those in the treatment group applied with cataplasm of polyphyllin. After 4,24,48,72 hours,the ankle diameter and circumference were measured. ELISA was used to test the interleukin-1β (IL-1β) andtumor necrosis factor (TNF) in peripheral blood. Western blotting was applied to detect the changes in TLR4 expression of monocyte.Results Compared with the control group, the added value of the diameter and circumference of ankle decreased significantly in the treatment group 4, 24,48 and 72 h after the treatment.IL-1β in the treatment group was lowered at 4,24 and 72 h. TLR4in the treatment group decreased at 48 h. Conclusion Cataplasm with polyphyllin can alleviate the acute inflammatory reaction in gouty joint of rat by reducing the expression of IL-1βand TLR4.
RÉSUMÉ
OBJECTIVE:To study the effects of caffeoylquinic acid derivative fractions (CADF) in Miao medicine Periploca forrestii on proliferation and secretion of inflammatory cytokines in tumor necrosis factor α(TNF-α)-induced human rheumatoid ar-thritis(RA)fibroblast-like synoviocytes MH7A,and explore its mechanism on anti-RA. METHODS:MH7A cells were divided in-to blank group,TNF-α model group,methotrexate group (positive control,20 mg/L) and CADF different mass concentrations groups(50,100,200,400 mg/L). Except for blank group,other groups received 50 μg/L of TNF-α to stimulate MH7A cells. Af-ter treated by suspension with TNF-α and related medicines for 24 h,the cell proliferation and contents of nitric oxide(NO),pros-taglandin E2 (PGE2),interleukin 1β(IL-1β),interleukin 6 (IL-6) in culture medium were detected. RESULTS:Compared with blank group,cell proliferation activity in TNF-αmodel group was significantly enhanced(P<0.01),contents of NO,PGE2,IL-1β, IL-6 in culture medium were significantly increased(P<0.01). Compared with TNF-α model group,cell proliferation in each ad-ministration group were significantly inhibited(P<0.05 or P<0.01),contents of NO,PGE2,IL-1β,IL-6 in culture medium weresignificantly decreased (P<0.01),showing certain dose-effect relationship with CADF. CONCLUSIONS:CADF can play the role in anti-RA by inhibiting the TNF-α-induced prolifera-tion of MH7A cells and reducing the secretion of inflammatory cytokines NO,PGE2,IL-1β,IL-6.
RÉSUMÉ
OBJECTIVE:To study the effects of caffeoylquinic acid derivative fractions (CADF) in Miao medicine Periploca forrestii on proliferation and secretion of inflammatory cytokines in tumor necrosis factor α(TNF-α)-induced human rheumatoid ar-thritis(RA)fibroblast-like synoviocytes MH7A,and explore its mechanism on anti-RA. METHODS:MH7A cells were divided in-to blank group,TNF-α model group,methotrexate group (positive control,20 mg/L) and CADF different mass concentrations groups(50,100,200,400 mg/L). Except for blank group,other groups received 50 μg/L of TNF-α to stimulate MH7A cells. Af-ter treated by suspension with TNF-α and related medicines for 24 h,the cell proliferation and contents of nitric oxide(NO),pros-taglandin E2 (PGE2),interleukin 1β(IL-1β),interleukin 6 (IL-6) in culture medium were detected. RESULTS:Compared with blank group,cell proliferation activity in TNF-αmodel group was significantly enhanced(P<0.01),contents of NO,PGE2,IL-1β, IL-6 in culture medium were significantly increased(P<0.01). Compared with TNF-α model group,cell proliferation in each ad-ministration group were significantly inhibited(P<0.05 or P<0.01),contents of NO,PGE2,IL-1β,IL-6 in culture medium weresignificantly decreased (P<0.01),showing certain dose-effect relationship with CADF. CONCLUSIONS:CADF can play the role in anti-RA by inhibiting the TNF-α-induced prolifera-tion of MH7A cells and reducing the secretion of inflammatory cytokines NO,PGE2,IL-1β,IL-6.
RÉSUMÉ
Type II innate lymphoid cells ( ILC2s) are widely distributed in the blood , intestines, trachea, lung, spleen, liver, animal fat and skin, and involved in the innate immune responses .ILC2s have attracted much atten-tion for its important roles in the conversion of white adipose to beige adipose .Studies have shown that ILC2s are essential for the proliferation and differentiation of adipocyte precursor cells , and they also play a vital role in anti-parasitic infection and allergic inflammation .This review discusses the discovery , differentiation , development , distribution and function of ILC2s, and their relationships with the browning of white adipose tissue for providing valuable references on understanding the pathogenesis , prevention and treatment of obesity and fat metabolism disorders .
RÉSUMÉ
Objective To evaluate the early diagnosis of patients with T1 and Tis breast cancer,and to ana-lyze and explore the diagnostic efficacy of breast cancer.Methods 242 patients with T1 and Tis breast cancer who received treatment were selected.The diagnostic accuracy and detection rate of two kinds of imaging methods for breast cancer were compared.Results 35(13.46%),91(35.00%),109(41.92%) and 25(9.62%) of the dense breast were classified by the X-ray of the breast.In the detection rate, fat type and a small amount of fiber gland body breast,the detection rate of X ray was significantly higher than that of ultrasound examination,the differences were sta-tistically significant (χ2 =8.74,21.70,all P0.05).For the dense breast,the detection rate of ultrasonography was significantly higher than breast X-ray,and the difference was statistically significant (χ2 =6.64,P0.05).Conclusion For a small amount of T1 and Tis breast cancer patients,the early screening accuracy and detection rate of ultrasound examination is more suitable for the volume of T1 and Tis in patients with breast cancer.
RÉSUMÉ
The last one and half a decade witnessed an outstanding re-emergence of attention and remarkable progress in the field of protein methylation. In the present article, we describe the early discoveries in research and review the role protein methylation played in the biological function of the antiproliferative gene, BTG2(/TIS21/PC3).
Sujet(s)
Méthylation , Protein MethyltransferasesRÉSUMÉ
Obej ctive To investigate the role of metastasis associated protein 1(MTA1)in estrogen reg-ulated expression of matrix metalloproteinase -9(MMP-9)and tissue inhibitor of metalprotease -1(TIMP-1) in estrogen receptor( ER ) positive breast cancer cells .Methods MTA1 knockdown cell model was generated based on MCF-7breast cancer cell line by transfected with MTA 1-shRNA.The mRNA and protein level of MMP-9 and TIMP-1 in wild type MCF-7(MCF-7WT)and MCF-7MTA1-shRNA before and after 17β-estradiol ( E2) treatment were examined by Real -time PCR and Western blot respectively .Results The MTA1-shRNA showed maximally 84.9%suppression of MTA1 expression in MCF-7,suggesting a satisfied MTA 1 knockdown cell model was established for subsequent experiments .After treated with E2 for 48 h,MCF-7WT showed an incre-ment of 46%(P<0.05)and 37%(P<0.05)of the mRNA and protein level of MMP -9 and a decrement of 32.3%( P<0.05)and 18.2%(P<0.05)of TIMP-1;MCF-7MTA1-shRNA showed a decrement of 32.3%(P<0.05)and 18.2%(P<0.05)of mRNA and protein expression of MMP -9 respectively but no significant differ-ence in TIMP-1 comparing with MCF-7WT before treated with Estradiol.After E2 treatment,MCF-7MTA1-shRNA didn′t show significant change of MMP -9 except decrements of 32.3%(P<0.05)and 18.2%(P<0.05)in the mRNA and protein levels of TIMP -1.Conclusion MTA1 may be involved in the pathway by which estrogen regulated the expression of MMP -9 but not TIMP-1 in ER positive breast cancer cells .
RÉSUMÉ
Objective To detection analysis of blood infectious disease markers in patients before blood transfusion or before surgery .Methods HBsAg ,anti-HBs ,HBeAg ,anti-HBe ,anti-HBc ,anti-HCV ,anti-HIV ,TP-Ab were detected for 3 542 cases of se-rum using chemiluminescence immunoassay(CLIA) and ELISA .Results For HBsAg ,there were 704 cases of positive among 3 542 cases ,the proportion was 19 .8% ;For anti-HCV ,there were 52 cases of positive among 3 032 cases ,the proportion was 1 .72% ;For anti-HIV ,there were 3 cases of positive among 3 049 cases ,the proportion was 0 .09% ;For TP-Ab ,there were 200 cases of positive among 3 153 cases ,the proportion was 6 .34% .The infection rate was different in different gender of HBV ,anti HCV ,anti HIV and TP-Ab .But for HBV ,anti-HCV and TP-Ab ,the detection rate of male was higher than female(P<0 .05);The infection rate was different in different age of HBV ,anti HCV ,anti HIV and TP-Ab different age .The detection rate of HBV and Anti-HCV in 21-40 years old was the highest ,They were 31 .9% and 2 .33% ;The detection rate of TP-Ab increases with age increased ,more than 60 years old was the highest ,up to 7 .55% .Detection of the above two methods ,for HBsAg ,there were 51 cases did not match ,the proportion was 1 .44% ;for anti-HCV ,there were 1 case did not match ,the proportion was 0 .03% ;for Tp-Ab ,there were 3 cases did not match ,the proportion was 0 .1% ;for anti-HIV ,CLIA agrees well with ELISA ,there were 3 cases of positive .The samples that did not match were detected by the third party verification of the reagent .The result displayed that CLIA was more accurate . Conclusion CLIA is a high-sensitivity detection method which could effectively avoid positive specimens missed ,detection of infec-tious disease markers in patients before transfusion or before surgery by CLIA had important significance .
RÉSUMÉ
BACKGROUND:The treatments of plantar fasci tis as an important cause of calcaneodynia are different in medical institutions, as wel as the therapeutic results. OBJECTIVE:To summarize various treatments of plantar fascia, and based on the pathogenesis and pathological mechanics of plantar fasci tis, to investigate the effect of various treatment methods and indications. METHODS:A computer-based online search of PubMed database and Wanfang database was performed for articled related to plantar fasci tis published between January 1993 and January 2014. The keywords were “plantar fasci tis, mechanism, treatment”in English and Chinese, respectively, by screening the titles and abstracts. Final y, 34 articles were included in result analysis. RESULTS AND CONCLUSION:The treatment of plantar fasci tis needs to fol ow the principle from noninvasive to invasive treatment. Stretching the plantar fascia and heel cord, using prefab-ricated orthotics, and wearing night splints are crucial for the treatment of plantar fasci tis. Local hormone injection can be used as first-line therapy for patients with acute plantar fasci tis if they can tolerate the adverse reactions due to hormone therapy. Platelet-rich plasma therapy has a promising prospect, but there is lack of experimental evidences. Extracorporeal shock wave therapy can be a choice for recurrent chronic intractable plantar fasci tis. Surgical intervention remains the last line of therapy, for which, rigorous screening is important, but it is not always effective at reducing pain.
RÉSUMÉ
PURPOSE: Many different scoring systems have been proposed for assessing the severity of atopic dermatitis. The SCORAD (SCORing Atopic Dermatitis) is one of the best validated systems, but is too complicated and time-consuming for routine clinical use. The aim of this study is to evaluate the Three Item Severity (TIS) score in routine clinical practice and to investigate the correlation with SCORAD and quality of life. METHODS: The study was done on 69 cases of atopic dermatitis randomly selected by SCORAD severity in Kangdong Sacred Heart Hospital pediatric allergy clinic from March 2003 to August 2003. Patients were from three months old to 15 years old. A trained pediatrician assessed the TIS score and simultaneous 10 item questionnaire about quality of life (QOL) was checked. RESULTS: According to the SCORAD, there were 21 (30.4%) mild cases, 26 (37.7%) moderate cases and 22 (31.9%) severe cases out of total 69 patients. According to the TIS score, 21 (30.4%) cases were 0-2 point, 16 (23.2%) were 3 point, 11 (16.0%) were 4-5 point and include 21 (30.3%) were 6-9 point. In QOL score, 21-30 points were most common (36.2%). There was significant positive correlation between TIS score and SCORAD (Spearman's rs= 0.86, P< 0.01). There was significant positive correlation between TIS score and QOL (Spearman's rs=0.89, P< 0.01). CONCLUSION: The TIS score is a reliable and simple scoring system for atopic dermatitis. It is particularly suitable in general practice, for routine clinical use.
Sujet(s)
Adolescent , Enfant , Humains , Eczéma atopique , Médecine générale , Coeur , Hypersensibilité , Qualité de vie , Enquêtes et questionnairesRÉSUMÉ
Background: Breast cancer is not only the most popular in women but is also one of the main causes of death among them in many countries. In Hanoi 1999, the prevalence of breast cancer was 21.8 per 100,000 of the population and was the main cause of death in women. In Ho Chi Minh city that prevalence was 17.1 per 100,000 of the population and was the second highest cause of death in women. Objectives: To assess the value of X-ray mammography and cytopathology test for breast cancer diagnosis of early stage Tis and T1. Subjects and method: A retrospective study was conducted among 103 breast cancer patients with malignant tumor size \uf0a32cm, who were admitted to K Hospital and Thanh Nhan Hospital from 01/2003 to 02/2008. Results:Breast malignant tumor was usually found most frequently at the upper outer quadrant. Around 86.4% of patients who were suspected with malignant lesion by X-ray mammography. Using biopsy test for breast cancer diagnosis, the results shows that 78.6% of patients were positive, 15.6% of cases were suspected and 5.8% had wrong diagnosis. Pathologic classifications were as followed: invasive lobular carcinoma: 78.6%, intraductal carcinoma in situ (Tis): 4.9%. Conclusion: X-ray mammography and cytopathology test are useful tools for the diagnosis of breast cancer.