No impact of repeated endoscopic screens on gastric cancer mortality in a prospectively followed Chinese population at high risk.

BACKGROUND: Gastric cancer (GC) is the leading cause of cancer deaths in China. Our study prospectively evaluated the impact of repeated endoscopic screens on GC mortality in a high-risk population in China. METHODS: Between 1989 and 1999, a population-based gastroscopic screening was conducted in 4,394 residents of Linqu County, China, a region with the highest rates of GC worldwide. Residents ages 35 to 64 years received initial gastroscopies with biopsies in 1989. Repeated endoscopies were performed in 1994 and 1999. Cancer occurrences and deaths were actively monitored throughout the entire period until July 2000. Mortality from GC was compared with expected values based on mortality rates obtained for Linqu in the 1990-1992 Chinese Cancer Mortality Survey. RESULTS: Between March 1989 and July 2000, 39,303 person-years were accumulated; 85 new GCs occurred, 29 (34.5%) were in early stage. Fifty-eight cases (68%) were identified at one of the screens. The number of observed deaths from GC (37) was close to the expected (36.8). The standardized mortality ratio was 1.01 (95% CI 0.72-1.37) for the entire cohort, 1.13 (95% CI 0.77-1.57) for males, and 0.65 (95% CI 0.26-1.32) for females. CONCLUSIONS: Despite high population coverage with repeated screens, no reduction in GC mortality was observed in this high-risk population in China.     

抗大肠癌噬菌体人单链抗体的初步鉴定及序列分析

目的 :对抗大肠癌细胞的单克隆噬菌体单链抗体进行初步鉴定和测序分析。方法 :采用细胞ELISA ,免疫组化 ,DNA序列测定和计算机分析方法 ,对 5个单克隆噬菌体抗体 (CH2 73,CH2 0 5 ,CH2 0 9,CHA12 ,CH72 3)进行初步鉴定和序列分析。结果 :5个抗体均对人大肠癌细胞、人胚肾上皮细胞和其它某些人肿瘤细胞反应 ,也与人正常肝细胞有弱阳性反应 ,但不与鼠源性的癌细胞和正常细胞反应。细胞免疫组化进一步证实了ELISA结果的正确性。大肠癌免疫组化对大肠癌组织有特异性的结合反应 ,而不与正常大肠组织反应。测序结果为CH2 73ScFv全长 732bp ;V ,D ,J分别属于VH3 30 D1 2 6 JH3 linker V1 13 JL2 ,GenBank序号为AY0 2 8777和AY0 2 8996 ;CH2 0 5全长 36 6bp ,V ,D ,J分别VH1 4 6 D6 13 JH3,GenBank序号为AF35 936 5 ;CH2 0 9,CHA12和CH72 3的ScFv基因完全相同 ,全长 72 3bp ,其VH DH JH与CH2 73ScFv基因中的VH DH JH 完全一致 ,V ,D ,J分别属于VH3 30 D1 2 6 JH3 linker L2 Jκ2 ,GenBank序号为AF36 3774。结论 :噬菌体抗体具有结合人大肠癌组织和细胞的活性 ,为进一步开发临床应用人源抗肿瘤抗体和小分子抗体片段奠定基础     

两种石油加工残油对制备可纺丝中间相沥青的影响

用常压液相炭化法制备中间相沥青，并用熔融法检验中间相沥青的可纺性，研究了汽油裂解残油和催化裂化重柴油参混比的不同对中间相沥青的制备速率，产率，中间相含量，显微结构以及可纺性的影响，指出最佳配比。     

成人成骨细胞与珊瑚羟基磷灰石的体外生物相容性

目的：研究成人骨髓成骨细胞与珊瑚羟基磷灰石（carolline hydroxyapatite,CHA)在体外培养条件下的生物相容性。方法：抽取健康成人骨髓组织，置于含体积分数为10％胎牛血清的DMEM培养基中培养，传代后改用含地塞米松、β-甘油磷酸钠和维生素C的条件培养基培养，分为CHA复合细胞组和单纯细胞组，不同时间用倒置相关显微镜，HE染色光镜及扫描电镜观察，MTT法进行细胞增殖测定，并进行细胞微量蛋白含量和碱性磷酸酶的定量检测，结果：成人骨髓成骨细胞体外培养时复合或不复合CHA均生长良好，表现出典型成骨细胞的形态特征和生物学特性，CHA利于细胞的贴附，生长与增殖，并对细胞的功能无不良影响，结论：CHA是较理想的骨组织工程支架材料，成骨细胞复合CHA用于骨缺损的修复，具有广阔的临床应用前景。     

全反式维甲酸对防治经皮冠脉介入治疗后再狭窄的临床疗效观察

目的观察不同剂量全反式维甲酸（ATRA）对防治经皮冠脉介入治疗（PCI）后再狭窄（Rs）的疗效。方法2004年7月至2005年9月连续入院行PCI的冠心病300例。随机分为全反式维甲酸正常剂量组（10mgt．i．d p．o，甲组）、强化剂量组（20mgt．i．d p．o，乙组）、对照组（丙组）。6个月后分别比较甲乙丙三组的再狭窄率、心脏事件发生率和心功能。结果300例患者中男性228例、女性72例。住院期间甲乙丙三组比较：心绞痛9％VS8％VS9％；再次急性心肌梗死（AMI）O％VS2％VS1％；再次缺血性血运重建（TVR）3％VS2％VS3％；心源性死亡4％VS6％VS4％，P〉0．05，无显著统计学差异。随访期间三组比较：心绞痛12％VS9％VS20％；再次AMII％VSO％VS1％；心源性死亡2％VS4％VS4％，P〉0．05，无显著统计学差异；再狭窄率3／33（9．1％）VS2／30（6．7％）VS12／32（37．5％）；TVR3％VS2％VS11％，P〈0．05，有显著统计学差异。结论常规剂量ATRA防治再狭窄安全有效。     

左心室巨大室壁瘤不同左心室成形方法的对比研究

目的研究左心室巨大室壁瘤的左心室成形方法,对改进的左心室心内膜环缩技术和传统的线性缝合技术进行近、远期疗效对比。方法自1992年1月至2004年12月,对148例左心室巨大室壁瘤患者进行手术治疗,按照手术中左心室成形方法不同分为两组,传统术式组:89例,采用传统的线性缝合成形技术;改良术式组:59例,采用改良的心内膜环缩成形技术,旷置梗死的心肌组织,再缝合环缩后的切口。采用多次信访、电话随访和门诊复查相结合的方法对两组患者术后的近、远期疗效进行对比观察。结果手术死亡5例(3.4%),其中传统术式组4例,改良术式组1例(P=0.320)。术后主要并发症为低心排血量和心室颤动。随访134例(93.7%),随访时间51.4±27.0月。远期死亡21例,术后早期心功能Ⅲ级以上是影响远期死亡的危险因素(P=0.000)。改良术式组5年和8年生存率明显优于传统术式组(91.6%vs.76.3%,P=0.040;91.6%vs.61.4%,P=0.000)。两组心功能分级(NYHA)和左心室射血分数(LVEF)术后早期和随访期间较术前改善和升高(P<0.05),改良术式组改善更明显。两组左心室舒张期末内径(LVEDD)术后早期与术前比较明显减小(P=0.000),但随访30个月时有重新增大的趋势(P=0.046)。传统术式组随访30个月时LVEDD扩大比率明显高于改良术式组(38.8%vs.16.7%,P=0.030)。结论左心室巨大室壁瘤的手术近、远期疗效满意,保持适当的左心室形态和容积是手术的关键。心内膜环缩法进行左心室成形是一种简单有效的手段,其远期结果优于线性缝合法。     

恶性肿瘤并发皮肤瘙痒症5例临床分析

作者认为恶性肿瘤引起的瘙痒有二种特点:(1)患者难以忍受;(2)抗组织胺药物无效。     

神经外科麻醉对体感诱发电位的影响

目的探讨神经外科手术麻醉对体感诱发电位（SEP）的影响,以期为麻醉和手术处理提供依据。方法随机抽取我科17例全麻手术病人,分成颅内疾病手术组（A组）与脊柱、脊髓疾病手术组（B组）,于术前、麻醉（诱导完成）、术始、术中、术毕和术后6个时程连续监测SEP的潜伏期、波幅及波形并记录。结果麻醉后SEP潜伏期延长5.96%,波幅下降24.00%,未出现波形消失的情况。结论麻醉抑制SEP,表现为潜伏期延长和波幅下降,但未出现波形消失的情况。     

Serum transforming growth factor-β1 level reflects disease status in patients with esophageal carcinoma after radiotherapy

AIM: To evaluate the relationship between changes in serum transforming growth factor β1 (TGFβ1) level and curative effect of radiotherapy (RT) in patients with esophageal carcinoma.METHODS: Ninety patients with histologically confirmed esophageal carcinoma were enrolled. Serum samples for TGFβ1 analysis were obtained before and at the end of RT. An enzyme-linked immunosorbent assay was used to measure serum TGFβ1 level. Multivariate analysis was performed to investigate the relationship between disease status and changes in serum TGFβ1 level.RESULTS: Serum TGFβ1 level in patients with esophageal carcinoma before RT was significantly higher than that in healthy controls (P ＜ 0.001). At the end of RT, serum TGFβ1 level was decreased in 67.82% (59/87) of the patients. The overall survival rate at 1,3 and 5 years was 48.28% (42/87), 19.54% (17/87)and 12.64% (11/87), respectively. Main causes of death were local failure and regional lymph node metastasis.In patients whose serum TGFβ1 level decreased after RT,the survival rate at 1, 3 and 5 years was 61.02% (36/59),28.81% (17/59) and 18.64% (11/59), respectively. The survival rate at 1 year was 17.86% (5/28) in patients whose serum TGFβ1 level increased after RT, and all died within 18 mo (P ＜ 0.01).CONCLUSION: Serum TGFβ1 level may be a useful marker for monitoring disease status after RT in patients with esophageal carcinoma.     

异丙酚对大鼠离体心脏缺血/再灌注损伤时心肌c-fos基因表达的影响

目的观察异丙酚对离体大鼠全心缺血再灌注损伤心肌c-fos基因表达的影响，探讨其对缺血再灌注损伤心肌保护作用机制。方法Wistar大鼠36只，随机分为对照组和异丙酚组，每组又分为缺血前、缺血30min和复灌30min3个亚组。通过离体心肌灌注模型，采用免疫组化及RT-PCR观察心肌c-fos蛋白及c-fo smRNA表达水平的变化。结果与缺血前相比，缺血30min及再灌注30min亚组的c-fos蛋白的光密度值及c-fos mRNA表达水平均增加（P〈0．01）；与对照组相比，异丙酚各亚组的c-fos蛋白光密度值及c-fos mRNA表达水平均降低（P〈0．01）。结论c-fos基因参与了心肌缺血再灌注损伤的基因调节。异丙酚可减轻心肌c-fos基因的表达，并可避免或减轻心肌缺血再灌注损伤。