射频消融治疗肝肿瘤315例报告

目的总结1999年6月至2003年8月用射频消融(radiofrequencyablation,RFA)治疗315例肝肿瘤病人的病例资料,探索RFA治疗肝肿瘤近远期疗效。方法采用了一次定位、多点穿刺,RFA联合肝动脉栓塞(TAE)、选择性门静脉栓塞(SPVE)治疗直径5~13cm的大肝癌,及经皮经肺经膈肌RFA治疗膈顶部肝癌。结果总并发症发生率为5.1%,无一例住院期间死亡。AFP阳性的169例肝癌病人中,RFA后有124例(73.6%)明显降低,其中有95例(56.2%)转阴。半年生存率为89.5%,1年生存率为80.1%,18个月生存率为61.4%,24个月生存率为48.3%,>36个月生存率为35.6%。结论采用TAE、SPVE及RFA一次定位多点穿刺法治疗无手术切除指征的中晚期(含大肝癌)的病人,疗效明显,总并发症发生率低。     

后腹腔镜下离断式肾盂成形术

目的探讨后腹腔镜下肾盂成形术的临床疗效. 方法腹腔镜下通过后腹腔途径对9例肾盂输尿管连接部狭窄行离断式肾盂成形术并对技术进行改进. 结果 9例手术均获成功,手术时间110～240 min,平均160 min.术中出血量30～80 ml,平均50 ml.术后住院8～18 d,平均11.2 d.术后并发症:皮下气肿(合并阴囊气肿)1例,漏尿2例.术后1～10个月B超示术侧肾盂无积水5例,轻度积水2例,中度积水2例.3例术后5个月IVU显示吻合口通畅. 结论后腹腔镜肾盂成形术微创、效果好,值得推广.     

消化道类癌的诊断与治疗(附44例报告)

目的探讨消化道类癌的诊断与治疗. 方法回顾性分析我院1990年1月～2005年4月44例消化道类癌的临床资料. 结果本组44例中直肠(包括直肠乙状结肠交界处)类癌29例发生率最高65.9%(29/44),结肠4例9.1%(4/44),阑尾1例2.3%(1/44),小肠2例4.5%(2/44),十二指肠2例4.5%(2/44),胃5例11.4%(5/44),肝1例2.3%(1/44).44例中治疗了39(39/44,88.6%),其中手术切除14例,内镜下粘膜切除术(EMR)20例(5例EMR后病理断端残余癌细胞又追加手术局部切除),内镜下直接钳除5例,5例未治疗.直径≤1 cm 30例占68.2%, 26例全部治愈,15例(50%)行EMR完全切除,其中20例肠镜随访10～84个月,均无复发,预后好;直径1～2 cm 4例占9.1%,手术局部切除,1例1年后肝转移;直径>2 cm 10例占22.7%,均位于直肠外,8例手术,2例未治疗,3例死亡,5例有远处或淋巴结转移,预后差.44例中6例发生远处或淋巴结转移,转移率13.6%. 结论内镜是诊断消化道类癌的首选方法,≤1cm的类癌可在内镜下行EMR切除.     

江苏口岸媒介生物监测结果分析

[目的] 加强对输入性医学媒介生物预警应急工作,防止媒介传入,保障我国人民身体健康.[方法] 对江苏口岸2002～2005年上半年输入性媒介生物截获情况进行统计分析.[结果] 2002～2005年上半年江苏口岸输入性媒介生物疫情截获率逐年上升.[结论] 传染病传播媒介生物的监测、病原携带检测和传入性风险分析,将作为世界卫生组织评估“监测技术水平、预警反应能力和处置实力”的重要指标之一,成为各成员国关注的焦点,同时也将成为各成员国间设置贸易技术壁垒的重要手段之一.因此,加强传染病传播媒介生物监测和控制工作势在必行.     

后程三维适形放疗治疗Ⅲ期非小细胞肺癌临床研究

OBJECTIVE: To evaluate the therapeutic efficacy and radiation complications of late course three-dimensional conformal radiotherapy (3DCRT) in patients with stage III non-small cell lung cancer (NSCLC). METHODS: Eighty-six patients with stage III NSCLC were randomly divided into group A (n=42) receiving conventional radiotherapy at the total dose of 66 to 70 Gy in 33 to 35 fractions completed in 6 to 7 weeks and group B (n=44) with late course 3DCRT at the dose of 24-30 Gy in 6 fractions (400-500 cGy per fraction every other day) after 40 Gy conventional radiotherapy, completed in 5 to 6 weeks. RESULTS: The efficacy rates in groups A and B were 55.0% and 82.9%, and the complete remission rates were 7.5% and 31.7% respectively, showing significant difference between the two groups (P<0.05). The 1- and 2-year survival rates of the patients in group A and B were 62.5% vs 78.0%, and 40.0% vs 53.7% respectively, without significant difference (P>0.05). The median survival time in groups A and B were 11.4 months and 19.8 months respectively. The major radiation complications observed in the two groups were grade I to II acute radiation esophagitis and hematopoietic toxicity. The later stage radiation complications in the two groups were grade I to II radiation lung fibrosis, occurring at a similar rate between the two groups. CONCLUSION: Late course 3DCRT produces better therapeutic effects than conventional radiotherapy in patients with stage III NSCLC.     

肿瘤抑制基因P53突变与肾细胞癌的关系

采用ＤＮＡ聚合酶链反应－单链构象多态性分析和直接序列测定技术，检测２５例肾细胞癌组织中Ｐ５３基因５－８外显子，２５例肾细胞癌仅有２例肿瘤组织存在Ｐ５３基因点突变，分别位于１５４和２７３密码子上，核苷酸序理分析突变形式分别为Ｇ→Ｔ，Ｃ→Ｔ。结果提示：肾细胞癌组织中Ｐ５３基因突变并不显著，表明肾细胞癌的发生可能是一个多基因变化的过程。     

测定孕妇血清α_1-酸性糖蛋白的初步报告

测定90例孕妇,24例妊娠高血压综合征(妊高征)及34例健康育龄妇女血清α_1-酸性糖蛋白(α_1AG)含量.结果表明,晚孕组较正常组明显降低(P<0.01);中、重度妊高征α-1AG的含量明显高于正常对照组(P<0.05);妊高征血清α_1AG的含量与尿蛋白量呈负相关.因此,动态观察α_1AG含量的变化对估计妊高征病情有一定指导意义.     

Quantitative observation by enzyme cytochemistry of human rectal adenocarcinoma cells killed by LAK cells

Activity of succinic dehydrogenase(SDH)and acid phosphatase(AcPase)of effector-target cells during the process of LAK cells killing HR8348 cells was estimated by enzyme cyto-chemistry technique.SHD positive granules and AePase gray level were assayed with MIAS-300image analyser.The results showed:(1)After cocultivation of effector and target cells for vari-ous times,the activity of AcPase of HR8348 cells was apparently higher than that of the controlgroup,and it increased following prolonged coincubation.SDH activity of target cells increasedmarkedly within 30 and 60 rain cocultivation,but became low after 90 min treatment.(2)Ac-Pase content within LAK cells at 60,90,120,180 and 240 rain cocultivation was significantlyhigher than that of control group(P<0.01).The phenomenon of high AcPase and SDH activitywithin effector-target cells indicates that the function of the two types of cells was in an activestate.At the early stage of effector-target combining,the increase of SDH with HR8348 cellsmay be related to defensive function of the target cells.Higher AcPase activity of target cells in-dicates the activation of lysosomal enzyme which serves as the material basis for autolysis of thecells.     

雌性大鼠、小鼠生殖系统与人子宫内膜甾体激素分泌细胞的研究

对雌性大鼠、小鼠的生殖系统,人的子宫内膜与蜕膜进行了3-β-羟基甾体脱氢酶(3-β-HSDH)和脂类的组织化学研究。结果表明:在大鼠和小鼠的卵巢内,颗粒黄体细胞和膜黄体细胞3-β-HSDH呈强阳性反应,卵泡膜内层细胞与间质细胞呈中等程度阳性反应;大鼠与小鼠子宫内膜的表面上皮与腺上皮呈阳性反应;人早孕期蜕膜中的子宫腺上皮细胞与大蜕膜细胞呈阳性反应:在大鼠与小鼠的输卵中偶尔见到阳性反应物质;在人的子宫内膜中,没有见到阳性反应。本研究证明,雌性大鼠和小鼠除卵巢有分泌甾体素的功能外,子宫也有分泌甾体激素的功能。人早孕期蜕膜组织中的子宫腺与大蜕膜细胞都能分泌甾体激素。