持续肝癌介入治疗与介入治疗后手术切除的疗效对比

目的探讨持续肝癌介入治疗与介入治疗后再行手术切除的临床疗效。方法选取青岛市中心医院2008年1月-2010年1月收治的原发性肝癌患者86例,采用随机数字法分为对照组和观察组,每组43例,对照组采用动脉栓塞持续介入治疗,观察组采用动脉栓塞介入治疗后再行手术切除治疗,比较两组患者治疗的临床疗效。结果观察组的病灶根除率、术后生存率、术后丙氨酸氨基转移酶(ALT)峰值、术后天冬氨酸氨基转移酶(AST)峰值均明显高于对照组(P0.05),术后复发率、并发症发生率均明显低于对照组,复发患者平均生存期明显长于对照组,差异均有统计学意义(P0.05)。结论动脉栓塞介入治疗后再行手术切除的临床疗效明显优于动脉栓塞持续介入治疗,病灶根除干净,术后复发率低,生存期较长,远期效果较好,值得临床推广使用。     

复方苦参注射液联合阿片类镇痛药用于肿瘤患者疼痛的临床观察

目的:观察苦参注射液联合阿片类镇痛药缓解恶性肿瘤患者癌性疼痛的疗效及不良反应。方法:选取恶性肿瘤合并癌性疼痛患者116例,以随机抽样法分为观察组(56例)和对照组(60例),观察组给予阿片类镇痛药联合复方苦参注射液,对照组单用阿片类镇痛药治疗,观察2组患者的镇痛效果。结果:在取得同等治疗效果的情况下(患者疼痛评分均≤3分,并稳定于该状态至少2周),观察组所用阿片类镇痛药的剂量低于对照组,2组比较,P<0.02,差异有统计学意义;不良反应方面,观察组低于对照组,2组比较,P<0.05,差异有统计学意义。结论:复方苦参注射液联合阿片类镇痛药可提高癌性疼痛患者镇痛效果,且降低了不良反应发生率。     

原发性肺类癌的MSCT表现

目的探讨原发性肺类癌MSCT表现,以提高对该病的认识。方法收集病理证实的肺类癌12例,回顾性分析其病理分类及MSCT表现。结果典型类癌8例,非典型4例;中央型5例,周围型7例。所有病例均为单发,术后均未见淋巴结转移。肿块呈分叶状9例,其中中央型3例、周围型6例;7例气道阻塞性表现,其中5例为中央型、2例周围型。动态增强扫描,类癌表现为延迟强化明显,平均最大强化40HU。结论原发性肺类癌周围型较中央型多见,MSCT可以更好地显示病变征象,肺类癌多为分叶状肿块,动态强化以延迟强化明显均匀强化,肿块内可有坏死或钙化,多直接或间接累及气道,同时伴有远侧肺野阻塞性表现。     

盐酸帕洛诺司琼对顺铂为主化疗引起恶心呕吐效果

目的 探讨盐酸帕洛诺司琼预防化疗药物引起恶心、呕吐的效果和不良反应.方法 选择120例有化疗适应证的肿瘤病人,化疗方案以顺铂为主.随机分为两组,实验组(n=60)化疗前30 min静脉注射盐酸帕洛诺司琼0.25 mg,注射时间超过30 s;对照组(n=60)化疗前30 min静脉滴注盐酸托烷司琼5mg,时间超过15 min.对两组化疗后l～5d的恶心程度、止吐效果及不良反应进行评价.结果 实验组在急性期、延迟期和全期的止吐有效率分别为92.36%、85.02%、80.91%,对照组分别为87.08%、67.25%、62.17%,两组延迟期和全期有效率比较,差异有显著性(χ2=55.34、58.22,P<0.05).实验组在第2～4天的恶心改善率分别为90.27%、78.51%、89.62%,对照组分别为70.05%、61.13%、70.83%,两组比较差异有显著性(χ2=56.25～59.33,P<0.05).两组不良反应差异无统计学意义(P>0.05).结论 盐酸帕洛诺司琼对预防化疗引起的恶心、呕吐有较好疗效.     

长骨转移瘤的影像学诊断

目的探讨长骨转移瘤的影像学特点,提高诊断准确率。方法选择具有明确原发病史或病理证实的45例长骨转移瘤患者为研究对象,对其骨转移瘤病灶的X线、CT和MRI影像表现进行回顾性总结及分析。其中X线检查18例,CT检查26例,MR检查18例(部分患者同时做2种或3种检查)。结果 X线发现20处病灶的基本特点为呈不规则形、多发斑点虫蚀样破坏或类椭圆形透亮区。无论累及骨端还是累及骨干病变,均伴有周围骨质破坏,并部分相邻皮质伴有不连续条带状骨膜增生。CT发现27处病灶均呈溶骨性骨质破坏,破坏范围可单侧或四周,部分周围形成软组织肿块。累及骨干分为皮质型和常见型。MRI发现20处病灶表现为长T1长T2、压脂像为高信号。结论长骨转移瘤在影像学表现上具有多样化特点,具体在X线、CT、MRI表现各自具有其特征性。相对而言CT、MRI在敏感性方面显示出较显著优势,尤其是MRI在发现早期髓腔病变具有较高敏感性。但X线检查在骨膜反应方面则优于其他检查。若将X线、CT和MRI三者相结合进行综合分析验证,对于诊断长骨转移瘤和与骨其他病变相鉴别具有显著意义,可提高诊断准确率。     

同步放疗联合介入化疗治疗中晚期子宫颈癌的临床观察

 目的　比较吡柔比星（THP）、5-氟尿嘧啶（5-Fu）联合顺铂（DDP）介入化疗联合放疗与单纯放疗治疗中晚期子宫颈癌的疗效和不良反应。方法　将48例经病理确诊的ⅡB～Ⅳ期子宫颈癌患者按随机数字表法分为同步放疗及介入化疗组（25例）和单纯放疗组（23例）,两组放疗剂量相同,同步放化疗组在放疗前后予以髂内动脉局部介入灌注化疗,THP 30～40 mg、5-Fu 0.50～0.75 g、DDP 40～ 60 mg,28 d为1个周期,共 3～4个周期 。对比两组的治疗效果及相关不良反应。结果　同步放疗及介入化疗组有效率为92.0 %（23／25）,3年生存率80.0 %（20／25）。单纯放疗组有效率为69.6 %（16／23）, 3年生存率为52.2 %（12／23）,两组差异有统计学意义（均P＜0.05）。两组相关不良反应发生率之间差异无统计学意义（均P＞0.05）,经对症处理后可耐受,为可逆的。结论　同步放疗联合介入化疗治疗中、晚期子宫颈癌可显著提高患者有效率及生存率,不良反应与单纯放疗相比无明显增加。     

Recombinant human endostatin combined with radiotherapy inhibits colorectal cancer growth

Background

To examine the effects of recombinant human endostatin combined with radiotherapy on colorectal cancer HCT-116 cell xenografts in nude mice.

Methods

Forty male BALB/c nude mice were injected with human colorectal cancer HCT-116 cells to form xenografts and then randomized into the following 4 groups (each group comprised ten mice): a control group, an endostatin group (20 mg/kg endostatin once a day for 10 days), a radiotherapy group (a 6-Gy dose was administered via a 6-MV X-ray on day 5 post-inoculation), and a combination therapy group (radiotherapy with endostatin treatment). The tumor growth inhibition rate were detected. CD31, vascular endothelial growth factor (VEGF), and hypoxia inducible factor-1α (HIF-1α) expression and microvascular density (MVD) were evaluated by immunohistochemistry. The expression of VEGF protein was also detected by western blotting.

Results

The tumor growth inhibition rate in the radiotherapy with endostatin treatment group was significantly higher than those in endostatin group or radiotherapy group (77.67% vs 12.31% and 38.59%; n?=?8 per group, P?<?0.05). The results of immunohistochemistry showed that treatment with radiotherapy induced significant increases in CD31, VEGF, and HIF-1α expression and MVD compared with treatment with saline, while treatment with endostatin or radiotherapy with endostatin induced reductions in CD31, VEGF, and HIF-1α expression and MVD compared with treatment with saline (n?=?8 per group, P?<?0.05). The results of western blotting showed that VEGF protein expression in radiotherapy group was significantly increased compared with that in the control group. However, VEGF protein expression in the endostatin or radiotherapy with endostatin groups was significantly decreased compared with that in the control group (n?=?8 per group, P?<?0.05).

Conclusions

Endostatin combined with radiotherapy can significantly inhibit HCT-116 cell xenograft growth, possibly by inhibiting angiogenesis and attenuating tumor cell hypoxia.

     

丹参酮Ⅱ_A对HeLa宫颈癌细胞凋亡的影响

目的:探讨丹参酮ⅡA对HeLa宫颈癌细胞凋亡的影响及其作用机制。方法:应用MTT比色法检测不同浓度丹参酮ⅡA对HeLa宫颈癌细胞的增殖抑制,采用烟酸己可碱33258染色法观察丹参酮ⅡA对HeLa细胞凋亡的影响,并用半定量逆转录聚合酶链反应法检测用药后Bcl-2和bax基因mRNA的表达水平。结果:丹参酮ⅡA对HeLa细胞增殖的抑制作用呈剂量依赖性;它能促使HeLa细胞发生凋亡;用药48h后Bcl-2基因mRNA的表达水平明显降低,而bax基因的表达则无明显变化。结论:丹参酮ⅡA对HeLa细胞的增殖具有显著的抑制及诱导凋亡作用。     

Influence of L-dopa on subtle motor signs in heterozygous Parkin- and PINK1 mutation carriers

IntroductionA latent nigrostriatal deficit and its possible clinical consequences in asymptomatic heterozygous Parkin and PINK1 mutation carriers (AMC) have been a matter of investigation in recent years. Notably, mild Parkinsonian signs in heterozygous mutation carriers can be so subtle that they may be missed if not specifically investigated.MethodsWe studied 15 heterozygous Parkin and PINK1 AMC and 18 age- and sex-matched mutation-negative controls using a standardized video, instructing the probands to perform relevant parts of the UPDRS III to investigate fine motor movements at baseline and after first-time L-Dopa administration. Additionally, available UPDRS III scores of mutation carriers from the past ten years were reviewed.ResultsAMC showed a reduced number of fine motor movements per second compared to controls at baseline (p = 0.04). L-Dopa improved motor performance numerically but non-significantly in AMC (p = 0.2301), but significantly in healthy controls (p = 6.1·10–5). Although none of the AMC reported symptoms, nine showed rigidity, bradykinesia, tremor, and postural instability when the UPDRS III was applied. Mean UPDRSIII scores significantly decreased after L-Dopa administration (p = 0.005), but did not increase over the past ten years.Conclusions(i) Heterozygous AMC show subtle motor abnormalities when a detailed, specialized motor examination is applied and compared to mutation-negative matched control subjects. (ii) The mild motor deficit present in a subgroup of heterozygous Parkin and PINK1 AMC appears to be non-progressive and responsive to L-dopa administration. (iii) Evaluating motor changes, their progression, and treatment response in AMC can provide valuable insights into possible early disease stages and compensatory mechanisms.