Treatment and prognosis of primary mediastinal seminoma

Objective: To investigate the surgical treatment and prognosis of the primary mediastinal seminoma. Methotis: Three cases with primary mediastinal seminoma from 1985 were retrospectively studied. They were male, aged 23, 36 and 32 years respectively. The primary symptoms were chest pain and coughing. The chest X-ray examination revealed solid round mass in the anterior mediastinum, with the diameters varied from 3 cm to 18 cm and a smooth clear edge. The diagnosis was not clearly in all three cases, and then operation was performed. Results: There were no operative deaths and complications. The tumor was radically removed in 2 cases and palliatively removed in 1 case. The post-operative pathological diagnosis is seminoma in all three cases. Radiotherapy were performed in 4 weeks after operation. All cases have been followed up to now, with 1 cases of death and 2 cases survival. Conclusion: Primary seminoma of the mediastinum is very rare. Operation is the main treatment for the primary mediastinal seminoma. Seminoma shows a good prognosis.     

APPLICATION OF TRANSVAGINAL CDFI IN THE DISTINGUISHMENT BETWEEN BENIGN AND MALIGNANT OVARIAN TUMORXUE

Objective To assess the value of transvaginal CDFI in the diagnosis of malignant ovarian tumors and to discriminate the benign from malignant ovarian tumors. Methods96 patients pelvic masses were studied by transvaginal ultrasonograph mass scoring, and by CDFI through pulsatility index (PI) and resistance index (RI) of peripheral blood flow of mass analyses.ResultsMass ultrasonic scoring: scoring＞9, 91.9% masses were malignant tumors. Scoring≤9, 91.5% masses were benign tumors. PI and RI of peripheral blood flow of masses were detected by CDFI: PI＜1.0, 92.5% cases; RI＜0.5, 97.4% cases were malignant tumors. The diagnosis match rate of malignant ovarian tumors was 97.0%. The diagnosis match rate of benign ovarian tumor was 96.2%. The diagnosis match rate was improved.ConclusionOvarian mass ultrasonic scoring＞9 and PI＜1.0, RI＜0.5 of mass peripheral blood flow are the special ultrasonic features of malignant ovarian tumor and the better methods to distinguish the benign ovarian tumor from the malignant one.     

Magnetic resonance imaging and microsurgical treatment of intramedullary hemangioblastoma of the spinal cord.

Thirteen cases of intramedullary hemangioblastoma of the spinal cord were studied radiologically, especially with magnetic resonance imaging (MRI). Microsurgery was used to remove the tumors in all cases. Signs and symptoms were improved in 84.6% of the cases after operation. The diagnosis and microsurgical techniques for excision of intramedullary hemangioblastoma of the spinal cord are discussed. This dis-ease should be differentiated from hydromyelia, intramedullary ependymoma, and vascular malformation of the spinal cord. Total removal of the tumor is recommened.     

APPLICATION OF TRANSVAGINAL CDFI IN THE DISTIN- GUISHMENT BETWEEN BENIGN AND MALIGNANT OVARIAN TUMOR

Objective To assess the value of transvaginal CDFI in the diagnosis of malignant ovariantumors and to discriminate the benign from malignant ovarian tumors. Methods 96 patients pelvic masses were studied by transvaginal ultrasonograph mass scoring, and by CDFI through pulsatility index (PI) and resistance index (RI) of peripheral blood flow of mass analyses. Results Mass ultrasonic scoring : scoring >9, 91.9% masses were malignant tumors. Scoring ≤<9, 91.5% masses were benign tumors. PI and Rl of peripheral blood flow of masses were detected by CDFI: Pl< 1 .0 . 92.5% cases; RI<0.5, 97.4% cases were malignant tumors. The diagnosis match rate of malignant ovarian tumors was 97.0% . The diagnosis match rate of benign ovarian tumor was 96 .2% . The diagnosis match rate was improved. Conclusion Ovarian mass ultrasonic scoring>9 and PI< 1 .0 , RI<0 .5 of mass peripheral blood flow are the special ultrasonic features of malignant ovarian tumor and the better methods to distinguish the benign ovarian tumor fro     

Diagnosis and surgical treatment of pancreatic endocrine tumors in 36 patients: a single-center report

Background Pancreatic endocrine tumors （PETs） are rare and their surgical treatment is often debated. The purpose of this retrospective study was to analyze the diagnosis and surgical strategy of functioning and non-functioning PETs. Methods From May 1980 to March 2006, 36 patients with pancreatic endocrine tumors at the Second Affiliated Hospital of Zhejiang University were retrospectively studied. Results Among the 36 patients, 29 （81%） had functioning tumors, and 7 （19%） had nonfunctioning tumors. Ninety-two percent of insulinomas were benign, whereas 4 （57%） of nonfunctioning PETs were malignant. The size of functioning tumors was （2.3i-0.3） cm, that of nonfunctioning tumors was less than （5.1~-0.5） cm. The combination CT and transabdominal ultrasonography resulted in a diagnostic sensitivity of 84%. Thirty-three primary lesions were precisely located in 32 patients （89%）. Atypical tumor resection was performed for 73% of functioning tumors, while typical pancreatectomy was performed for 6 （85%） of nonfunctioning tumors. Moreover, 5 liver resections and 1 lymph node dissection were performed. During the follow-up, fifteen complications occurred in 12 （36%） patients after operation. The 5-year survival rate for patients with benign tumors was 92% compared to 50% for those with malignant tumors. Surgical cure was achieved in 95% of patients with benign insulinomas. Conclusions Surgical strategy for PETs depends on the size and location of the tumor and the risk of malignancy. The optimal surgical procedure is key to prevent postoperative complication. Radical resection including initial and metastatic lesion may benefit patients with maliqnant PETs.[第一段]     

Clinical and CT histological diagnosis of orbital tumors

Preoperative histological diagnosis of orbitaltumors is the key to decide the necessity of the operation or to choose right surgery. This paper reviewed 117 cases of orbital tumor in our hospitalfrom Feb. 1980 to May 1995. Emphasis was puton CT presentations of the tumors and clinical value of CT in the histological diagnosis of orbital tumors.1 SUBJECTS AND METHODSIn 117 patients with orbital tumor, there were56 males (47. 9 %) and 61 females (52. 1 %). Thediagnosis of 108 cases (92…     

Follicular dendritic cell sarcoma of the appendix： A case report

Objective To discuss the diagnosis of follicular dendritic cell sarcoma （FDCS） of the appendix, clinicopathologic features and the treatment. Methods A case of postoperative recurrent FDCS deriving from the appendix was reported. The pathological changes and immunohistochemistry were evaluated. Results The histopathology of the specimen obtained from the recurrent tumor was identical with that of the first laparotomy. Immunohistochemically, the tumor cells were positive for CD21, CD35,     

COMBINED SURGICAL THERAPY FOR HEPATOLITHIASIS

Objectve To evaluate the combined surgical therapy for calculi of intrahepatic duct. Methods One hundred and eight cases of hepatolithiasis treated in our hospital from January 1986 to September 2003 were summarized and analyzed retrospectively. The primary surgery included 57 cases of biliary tract exploration and cholangiolithotomy, 26 cases of cholangiojejunostomy, and 25 cases of partial hepatectomy. Of these cases, 156 operations were performed totally. There were 36 patients undergoing two or more operations for cholangiolithiasis problem. Fiberoptic choledochoscopy was employed to examine and remove the residual stones during and after operation in all cases. Results The residual stone rates were 57.89% (33/57), 26.92% (7/26), and 24.0% (6/25) for biliary tract exploration and cholangiolithotomy, cholangiojejunostomy, and partial hepatectomy, respectively. Fiberoptic choledochoscopy was utilized pre- and post-operatively for each patient, which was performed 2 to 9 times on each case. Following the combined treatment,the rate of residual stone after operation decreased to 12.96% (14/108). Conclusions The combined surgical therapy is valuable for resolving the problem of hepatolithiasis in most of the patients. Regarding the clinical outcomes of different surgical procedures, partial hepatectomy is superior to cholangiojejunostomy or biliary tract exploration and cholangiolithotomy. Fiberoptic choledochoscopy is also important to reduce the occurrence of residual stones and the rate of reoperation.     

CLINICAL DIAGNOSIS AND TREATMENT OF NONFUNCTIONING PHEOCHROMOCYTOMAS IN 14 PATIENTS

Objective To analyze the clinical characteristics of nonfunctioning pheochromocytoma, and to evaluate the efficacy of ^131I-metaiodobenzylguanidine (MIBG) scan in the diagnosis and perioperative treatment of nonfunctioning pheochromocytoma. Methods The clinical data of 14 patients with nonfunctioning pheochromocytoma were analyzed retrospectively. Plasma free corticoid, renin, aldosterone, and urine catecholamines levels were estimated. B-mode ultrasonography, computed tomography scan, thoracic X-ray and ^131I-MIBG were used. Results All patients with nonfunctioning pheochromocytoma had no hypertension and the tumors were found incidentally. The 24 hours urine catecholamines levels in 80% (8/10) patients were normal. The positive rate of ^131I-MIBG was 80% (8/10) and the specificity was 100%. All patients underwent surgical operation of tumor resection. No preoperative volume expansion was given to all patients. All tumors were resected completely, and no death accident happened. There was no recurrence and metastasis after operation by long-term follow-up. Conclusin ^131I-MIBG scan is the first choice technique for the diagnosis ofnonfunctioning pheochromocytoma. Blood volume expansion is unnecessary before resection ofpheochromocytoma.     

Breast

<正>209169 Analysis of the treatment and prognosis of recurrent breast phyllodes tumor/Fang Yi(Dept Abdomin Surg,Oncol Cancer Hosp(Institute),Chin Acad Med Sci,Beijing 100021)…∥Chin J Oncol.-2009,31(1).-72~74Objective To explore the methods of diagnosis,treatment and prognosis for patients with recurrent breast phyllodes tumor.Methods Clinicopathological data of 26 patients with pathologically proven recurrent phyllodes tumors treated from March 1972 to June 2006 were retrospectively analyzed.Results The mean age of the 26 cases was 45 years,and the median follow-up duration was 83 months.The mean overall survival time of this series was 96 months.The primary breast phyllodes tumor was ≥5 cm in 10 cases with a recurrence rate of 60.0%(6/10 cases);<5 cm in 16 cases with a recurrence rate of 31.3% 5/16(cases).After surgical removal of the breast primary tumor,the recurrent tumor was ≥5 cm in 14 cases with a re-recurrence rate of 35.7%(5/14 cases);<5 cm was in 12 cases with a re-recurrence rate of 50.0% (6/12 cases).There was no statistically significant relationship between the(primary and reccurent)tumor size and recurrence rate(P=0.094,P=0.383)or prognosis,(P=0.142,P=0.486).The benign or malignant nature of the breast phyllodes tumor was singificantly correlated with the rate of local re-recurrence(P=0.046)and prognosis(P=0.028).     

平扫液体衰减反转恢复及增强T1WI序列对脑转移瘤的综合诊断价值

目的 探讨平扫液体衰减反转恢复(FLAIR)与增强T1WI序列结合后对脑转移瘤的综合诊断价值.方法 48例脑转移瘤患者原发灶均经过纤维支气管镜活检或手术活检病理证实,所有患者均进行了FLAIR平扫及增强T1WI扫描,对于FLAIR平扫发现可疑病变而增强T1WI扫描表现阴性的患者,加扫增强FLAIR序列.对比分析192处脑转移瘤病灶在平扫FLAIR及增强T1WI序列的显示情况,进一步分析其综合诊断价值. 结果 192处脑转移瘤病灶中,平扫FLAIR序列检出可疑病灶102个,能够明确瘤灶边界的有56个;增强T1WI序列检出病灶183个,能够明确瘤灶边界的有181个;两种序列结合以后,瘤灶检出192个. 结论 FLAIR有助于发现瘤周水肿,对于皮层区域病灶敏感性较高,增强T1WI有助于发现平扫不能发现的病灶,诊断特异性较高,二者结合可以提高脑转移瘤的诊断正确率. Abstract： Objective To investigate the synthetic diagnostic value of plain FLAIR combined with contrast-enhanced T1WI sequence in intracranial metastatic tumor. Methods Retrospective analysis of 48 patients with intracranial metastatic tumor, the primary tumor have been confirmed by fiber bronchoscope biopsy or surgical biopsy. All the patients were performed MRI scans with plain FLAIR and contrast-enhanced T1WI sequence. Contrast-enhanced FLAIR scans for suspicious lesions in plain FLAIR but negative in contrast-enhanced T1WI. Comparative analysis the appearances of 192 lesions in plain FLAIR and contrast-enhanced T1WI sequence, and analyze the synthetic diagnostic value of both sequence. Results One hundred and two lesions were detected in plain FLAIR sequence, and 56 lesions with the clear border.One hundred and eighty-three lesions were detected in contrast-enhanced T1WI sequence, and 181 lesions with the clear border. And 192 lesions were detected with plain FLAIR combined with contrast-enhanced T1WI sequence. Conclusions Plain FLAIR scans are useful to detect edema of the metastatic tumor, and have higher sensitivity of the cortex region lesions. Contrast-enhanced T1WI scans are useful to detect the negative lesions in plain MRI scans, and have a higher diagnostic specificity. A combination scans of both sequence can improve the diagnostic accuracy.     

核增殖抗原和生存素蛋白在胃肠道间质瘤中的表达与意义

目的 探讨核增殖抗原(Ki-67)和生存素(survivin)蛋白在胃肠道间质瘤(GIST)中的表达及临床意义.方法 应用免疫组化SP法和病理图像分析系统检测85例胃肠道间质瘤(GIST)患者中Ki-67和survivin的表达情况,结合临床病理学资料分组比较并进行统计学分析.结果 85例GIST中Ki-67和survivin表达的平均灰度值在良性组、潜在恶性组、恶性组中依次递减, 即它们的阳性表达水平逐渐增高.三组两两比较,各组的平均表达水平差异有统计学意义(P<0.05).而且在41个恶性病例中,有浸润或转移的亚组的Ki-67和survivin表达水平显著高于无浸润转移亚组的表达水平(P<0.05).同时统计分析表明GIST中Ki-67和survivin表达有显著的正相关性(P<0.01).结论 Ki-67和survivin高表达导致肿瘤细胞的增殖旺盛和凋亡抑制是GIST发生恶变以及向外侵袭转移的重要机制之一,两者可能用以协助判断GIST的良恶性以及预测肿瘤转移及预后. Abstract： Objective To investigate the expression of Ki-67 and survivin in gastrointestinal stomal tumors (GIST) and their clinical pathologic significance. Methods The expression of Ki-67 and survivin were detected in 85 cases of GIST by immunohistochemical technique. Futhermore,multi-function precise color-image measure system was used for quantitative analysis.The relationship between expression and clinical pathologic data was analyzed.Results Among 85 GISTs, the expression of Ki-67 and survivin in benign,potentially malignance and malignance group were increased gradually.There was a significant difference among the groups of each gene's expression(P<0.05). There was also significant difference in the expression of Ki-67 and survivin between the metastasis subgroup and the non-metastasis subgroup. There was significant positive correlation between Ki-67 and survivin expression(P<0.05). Conclusions The unbalance of the cell proliferation and apoptosis resulted by the increased expression of Ki-67 and survivin is one of the important mechanism in carcinogenesis process and invasion and metastasis of GIST. The expression of Ki-67 and survivin maybe can serve as an important predicting maker for malignancy degree and metastasis and prognosis of GIST.     

低分子量肝素在胸部肿瘤合并高凝血状态病人围术期的临床应用

目的 使用低分子量肝素(LMWH)预防胸部肿瘤合并高凝血状态病人的围术期血栓性疾病的发生.方法 对2006年1月至2007年10月我科收治的合并高凝血状态的食管癌、贲门癌、肺癌病人,在围术期皮下注射低分子量肝素,每日1次,从术前3～5 d开始直至病人下床,观察术中出血量及术后胸液量,并统计血栓性疾病发生率.结果 该组病人围术期血栓性疾病发生率得到了明显控制.结论 低分子量肝素对预防胸部肿瘤合并高凝血状态病人的围术期血栓性疾病的发生有明显效果,安全可靠. Abstract： Objective To evaluate the efficacy of low molecular weight heparin for preventing thromboembolism disease in perioperative of thoracic tumor with blood hypercoagulabale state. Methods From January 2006 to October 2007, we diagnosed and treated 72 patients with lung cancer and carcinoma of esophagus and cardia. All the patients were treated with LMWH qd from the 3 -5 days before operation until ambulation after operation. To observe the postoperative total amount effusion and to statistic of incidence of thromboembolism disease. Results Incidence of thromboembolism disease decreased more significantly of this group than usual. Conclusions Application of LMWH for preventing thromboembolism disease in periopetive of thoracic tumor with blood hypercoagulabale state is an effective, safe and reliable treatment.     

胃间质瘤的螺旋CT诊断

目的 分析胃间质瘤(GST)的CT表现及其诊断价值.方法 回顾性分析10例经手术病理证实为GST患者的CT检查资料,行CT平扫者10例,CT平扫和增强扫描者5例.结果 肿块向腔外生长者较多(6/10),表现为类圆形或分叶状肿瘤;发生于胃窦部1例,胃体部6例,胃底部1例,贲门2例.10例GST中,良性3例,肿块直径多<5 cm,密度较均匀,边界清楚,均匀强化;恶性7例,肿块直径多>5 cm,密度多不均匀,边界可清楚或不清楚,强化不均匀;6例肿块内有坏死.10例均行手术后光镜观察及免疫组化检查,10例CD117均为阳性,7例CD34阳性.结论 CT检查对于GST的定位准确及定性诊断有重要价值. Abstract： Objective To analyze CT features of gastric stromal tumors(GST) and evaluate CT in the diagnosis of the disease. Methods The CT scanning datas of 10 cases with pathologically-proved GST were retrospectively analyzed.Among the 10 cases, five cases were scanned with contrast enhanced scanning, and the other 5 cases without enhanced scanning.Results Predominant extraluminal growth of tumors made a large proportion in our cases(6 of 10), which appeared mainly as oval or multilobular in shape. The tumors originated from gastric antrum (n=1), gastric corpus (n=6), gastric fundus (n=1) or cadiac orifice (n=2).Among the 10 cases, 3 cases were benign and 7 cases were malignant. The benign lesions were usually below 5 cm in size with well-defined margin and displayed homogeneous density and enhancement,while the malignant lesions were over 5 cm in size and were well-defined or ill-defined, combined with necrosis within 6 of 7 malignant tumor and displayed heterogeneous density and enhancement. 10 cases were examined by light microscopy and immunohistochemistry after operation, all 10 cases were positive for CD117, 7 cases for CD34.Conclusions CT can precisely localize GST and is also very helpful in differentiating benign from malignant GST.     

树突状细胞与白细胞介素-2抗肿瘤作用的比较研究

目的 抗原冲击的树突状细胞(DC)与肿瘤周围皮下给予白细胞介素-2(IL-2)分别治疗大肠癌,目的 在于比较二者抗肿瘤作用,为其应用于临床提供实验依据.方法 将荷C26结肠癌的BALB/C(H-2d)小鼠随机分为对照组、IL-2治疗组、抗原冲击的DC治疗组.抗原冲击的DC治疗组在荷瘤后第1、8、15、22天于右侧腹股沟皮下注射抗原冲击的DC;IL-2治疗组在荷瘤后第1～5、8～12、15～19、22～26天于肿瘤周围皮下注射IL-2,对照组在相同的部位注射PBS液.观察荷瘤小鼠的肿瘤体积、生存期和存活率.结果 两种治疗方案均能明显抑制肿瘤生长,延长小鼠的生存期(P<0.05);但抗原冲击的DC组较IL-2组更能延长荷瘤小鼠的生存期(P<0.05).结论 抗原冲击的DC组较IL-2组明显延长荷瘤小鼠的存活时间而达到更明显的抗肿瘤作用. Abstract： Objective Tumor lysate-pulsed DC and systemic administration of interleukin-2(IL-2) was used in our experiment to therapy mice colon tumor model in order to investigate its anti-tumor mechanisms and provide preclinical rationale experimental theory. Methods C26 tumor-bearing BALB/C(H-2d) mice were randomized over control groups and IL-2 groups, C26 tumor lysate-pulsed DC groups. C26 tumor lysate-pulsed DC groups were injected s.c with tumor lysate-pulsed DC at days 1,8,15,22. IL-2 groups were injected peritumorally with IL-2 at days 1-5,8-12,15-19,22-26.Control groups were injected peritumorally with PAS.The tumor volume, the survival time and the survival rate was recorded. Results The two therapeutic methods inhibited significantly the tumor growth and enhanced survival(P<0.05). The therapeutic effect of C26 tumor lysate-pulsed DC treatments is much better than the effect of IL-2 treatments. Tumor lysate-pulsed DC groups enhanced survival in comparison with IL-2 groups(P<0.05). Conclusions The therapeutic effect of C26 tumor lysate-pulsed DC treatments was much better than the effect of IL-2 treatments in survival.     

妇科恶性肿瘤化疗患者262例血糖观察

目的 观察化疗对妇科恶性肿瘤患者血糖的影响.方法 回顾性分析我科收治的262例恶性肿瘤患者化疗前、中、后糖尿病的发生情况,对并发糖尿病患者进行随访.结果 化疗后空腹血糖升高24例,糖尿病8例,糖耐量减低11例,一过性血糖升高5例.PT方案化疗较PVB方案化疗更易引起血糖增高(P＜0.05).结论 恶性肿瘤患者化疗后可引起血糖增高,甚至发生糖耐量减低或2型糖尿病. Abstract： Objective To explore the effect of chemotherapy on glucose metabolism in patients with gynecological malignant tumor.Methods Two hundred and sixty -two patients with gynecological malignant tumor who treated with chemotherapy were analyzed retrospectively.The incidence of diabetes mellitus as analyzed.The occurrence of diabetes before, during and after chemotherapy for patients with malignant tumors was observed.Results Total 24 cases had elevated fasting blood glucose after chemotherapy.Among them ,8 cases were diagnosed as diabetes mellitus, 11 cases were diagnosed as impaired glucose tolerance.Significant difference of blood glucose was observed between patients treated with PT chemotherapy and those who treated with PVB chemotherapy(P ＜ 0.05).Conclusions Chemotherapy could make the blood glucose of patients with malignant tumor increase, and may result in decreased sugar tolerance or type 2 diabetes.     

重组改构人肿瘤坏死因子治疗恶性胸腔积液疗效观察

目的 评价重组人改构肿瘤坏死因子(rmh-TNF)治疗恶性胸腔积液的疗效和不良反应.方法 38例恶性胸腔积液患者排尽胸水后,注入单药rmh-TNF 2×106 IU,2次/周,观察其疗效、生活质量和不良反应.结果 38例中完全缓解12例,部分缓解23例,无效3例,总有效率92%;不良反应发生率有发热76%(29/38),胸痛44%(17/38).结论 rmh-TNF局部治疗恶性胸腔积液疗效可靠,不良反应少,生活质量提高,是治疗恶性胸腔积液的有效药物,尤其是治疗因恶性胸腔积液不能耐受全身静脉化疗的患者. Abstract： Objective To evaluate the effect and side effect of recombinant mutant human tumour necrosis factor (rmh-TNF) in the treatment of malignant hydrothorax. Methods Thirty-eight patients with malignant hydrothorax were observed rmh-TNF 2×106 IU were injected intrapleurally after complete drainage, two times a week,until the malignant effusion no longer appeared,to observe the effect,quality of life and side effect.Results Among 38 patients with malignant hydrothorax,12 patients obtained complete response(CR),23 patients partial response (PR)and 3 patients no change (NC), the overall response rate was 92%. The adverse reactions were fever 76%(29/38), and chest pain 44%(17/38).Conclusions The rmh-TNF is effective with minor side effect in the treatment of malignant hydrothorax,improve the quality of life.Therefore it is a favorable treatment of choice,especilly to that who can't tolerant chemotherapy.     

四种抗体联合检测在SLE患者中的诊断价值

目的 探讨抗双链DNA(dsDNA)抗体、抗Smith(Sm)抗体、抗核小体抗体(AnuA)、抗组蛋白抗体联合检测在系统性红斑狼疮(SLE)患者中的诊断价值.方法 抗dsDNA抗体、抗Sm抗体、AnuA、抗组蛋白抗体均采用欧蒙斑点法测定98例SLE患者(分为活动期和稳定期)、90例其他结缔组织病患者及40例健康人血清中的四种自身抗体.结果 98例SLE患者中抗dsDNA抗体、抗Sm抗体、AnuA、抗组蛋白抗体阳性率分别为45.9%、 29.6%、 57.1%、33.6%,特异性分别为100%、99.2%、98.5%、89.2%;抗dsDNA抗体和AnuA在活动期SLE中的敏感性与稳定期相比差异有统计学意义(P<0.05);抗dsDNA抗体和AnuA以及四种抗体联合检测时阳性率分别为70.4%和79.6%,明显高于其中任何单项检测的阳性率,且明显高于疾病对照组,差异有统计学意义(P<0.05).结论 所检测的四种抗体在SLE中都具有很高的特异性和敏感性,其中抗dsDNA抗体和AnuA对活动期SLE具有很好的诊断价值,抗体的联合检测可较大程度提高SLE检测阳性率,四种抗体有明显的互补作用,尤其抗dsDNA抗体和AnuA的联合检测具有很好的组合价值. Abstract： Objective To investigate the diagnostic significance of combined detection of anti-double stranded DNA antibody(anti-dsDNA),anti-Smith antibody(anti-Sm)and antinuclesome antibody(AnuA) and anti-histone antibody in systemic lupus erythematosus(SLE),and evaluate the significance of combined detection of these autoantibodies in the diagnosis of SLE. Methods Ninety-eight cases of SLE patients who were divided into active and stable stage group and 90 disease controls and 40 healthy people were detected with Euro immunoblot assay.Results In the assays mentioned above. The serum positive rates of anti-dsDNA,anti-Sm, AnuA and anti-histone antibody were 45.9%,29.6%,57.1% and 33.1% in SLE, and the specificities were 100%,99.2%,98.5% and 89.2% respectively in patients with SLE.The positive rates of anti-dsDNA and AnuA in active SLE group were 57.5%,65.1%,which was apparently higher than that in the stable stage group;The sensibility of combined detection of anti-dsDNA and AnuA was 70.4%, four autoantibodies combined detection in SLE was 79.6%, which was apparently higher than any single autoantibodies, the difference had statistical significance. Conclusions These four autoantibodies have very high sensibility and specificity respectively, combined detection of four autoantibodies can markedly raise the relevance ratio in SLE, while their specificity didn't have a visual reduction. Especially, the sensibility of combined detection of anti-dsDNA and AnuA can markedly increased in active SLE patients. This compose can raise effectively the diagnosis of active SLE.So the detections of the four antibodies are complementary for the diagnosis of SLE.     

曲美他嗪治疗不稳定型心绞痛

目的 探讨曲美他嗪治疗不稳定型心绞痛(UAP)的临床疗效及对内皮素(ET)、一氧化氮(NO)的表达影响.方法 随机选择UAP患者80例,入选患者被随机单盲分为曲美他嗪组40例和常规治疗组40例.观察统计两组治疗前1周和治疗结束后1周心绞痛发作次数、自拟的疼痛强度及持续时间记分值,检测治疗前后患者血浆ET和NO水平的变化.结果 曲美他嗪组和常规治疗组比较,治疗后患者疼痛发作频率、疼痛强度及持续时间记分均有明显减少,但曲美他嗪组的疗效比常规治疗组明显,差异有统计学意义(P<0.05). 两组治疗都可改善不稳定型心绞痛患者心电图ST段的偏移,但曲美他嗪组的疗效比常规治疗组显著, 差异有统计学意义(P<0.05).两组都可改善心绞痛患者心电图表现,但差异无统计学意义(P>0.05).两组患者治疗后血浆ET水平明显减低,NO水平明显升高,但曲美他嗪组比常规治疗组显著, 差异有统计学意义(P<0.01).结论 曲美他嗪组对不稳定型心绞痛患者疗效明显升高,这种疗效与改善血管内皮细胞功能有关. Abstract： Objective To observe the effects of trimetazidine on plasma concentration of endothelin(ET) and nitric oxide(NO) in patients with unstable angina pectoris(UAP).Methods Randomly selected 80 patients with unstable angina pectoris, patients were randomly divided into trimetazidine group with 40 patients, and conventional treatment group with 40 patients. The clinical effect was observed by the changes of the angina pectoris frequencies and pain period and intensity score per mean day at 1 week pro-treatment and 1 week post-treatment. Plasma concentrations of ET and NO were measured before and after the treatment.Results The frequency, intensity and duration of pain score was significantly reduced in both groups, and the effect of trimetazidine group was obvious than the conventional treatment group, the difference was statistically significant(P<0.05). The two groups can improve the treatment of unstable angina patients ECG ST section of the shift, and the effect of trimetazidine group was obvious than the conventional treatment group, the difference was statistically significant(P<0.05). Two groups of patients can improve angina and ECG, but the difference was not statistically significant(P>0.05). In the two groups, plasma ET was significantly reduced, and plasma NO was significantly elevated,the effect of trimetazidine group was obvious than the conventional treatment group, the difference was statistically significant(P<0.01).Conclusions The effects of trimetazidine on patients with unstable angina pectoris is significantly elevated, and is significantly beneficial to protect the endothelial function.