Intraperitoneal hemorrhage during and after percutaneous radiofrequency ablation of hepatic tumors: reasons and management

Marandyiofr estquudeinecsy h(a RveF) e satabblalitsiohned as th ea m rionliemal olyf invasive treatment of hepatic neoplasms·1-6 Good outcomes with low morbidity and mortality have been identified·Although relatively safe, a broad spectrum of complications, of which the hemorrhage is the most common, has been reported along with the increasing use of RF ablation·7-9 Hence, it is absolutely essential to minimize complications and learn how to deal with them properly·The purpose of this st…     

Thy-1肿瘤标记物在肺癌组织中的异常表达及其对肺癌患者预后的影响

目的通过免疫组织化学染色的方法了解Thy1在肺癌组织中的表达状况,分析其对于非小细胞肺癌患者预后的影响,并了解Thy1与p53表达之间的相关性,为Thy1在肺癌中表达机理的进一步研究提供思路。方法以组织芯片的形式,采用免疫组化信号催化放大法,对175例包括不同病理类型的肺组织标本中Thy1的表达情况进行检测,并对其中的91例非小细胞肺癌进行Thy1和p53的联合检测。分析这两种蛋白表达之间的相关性,结合临床病理资料及随访结果分析Thy1与患者生存预后的关系。结果Thy1抗体特异性地在不同病理类型肺癌细胞的胞核中有强阳性染色,89例(56.7%)为Thy1细胞核染色阳性。91例非小细胞肺癌患者预后的单因素和多因素分析显示,TNM分期、淋巴结转移和Thy1在细胞核中高表达是影响患者预后的独立因素。分层研究提示,无淋巴结转移组中,Thy1细胞核阴性患者的生存时间明显长于阳性患者(分别为46.42个月和38.56个月,P=0.0207)。Thy1和p53两者表达之间存在显著的相关性(P<0.001)。结论Thy1在肺癌细胞核内特异性高表达是非小细胞肺癌患者预后的影响因素之一。Thy1在细胞核内的异常高表达可以作为肺癌病理诊断的标记物。     

第三肝门成形术在Budd-Chiari 综合征介入治疗中的应用

目的 探讨第三肝门成形术[经皮腔内血管成形术(PTA)及支架置入术]在Budd-Chiari综合征(BCS)介入治疗中的临床应用价值。方法 本组20例BCS患者,其中男12例,女8例,年龄17～53岁,采用直接或标识下经股静脉或颈静脉第三肝门成形术,或采用Rendez-vous技术第三肝门成形术。结果 全部病例实施第三肝门靶血管PTA及支架置入术,均获得成功,未出现严重并发症。单纯PTA治疗12例,支架置入术8例(共置入支架9个)。术后随访3～54个月,临床治愈10例,有效7例,无效3例。有效率为85％。结论 第三肝门成形术作为治疗肝静脉型BCS是一种安全、有效的新方法,有着与第二肝门成形术同等的治疗价值。     

172例肝癌射频消融治疗预后因素分析

目的探讨原发性肝癌射频消融（RFA）治疗的生存期及影响因素,进行单因素及多因素分析,以指导RFA消融治疗。方法1999至2004年172例原发性肝癌行RFA治疗,其中150例（87．2％）不能或不宜手术治疗。分析24项与生存期可能相关的因素,探讨与生存期的相关性。随访时间4～51个月,随访率94．8％（163例）。单因素分析采用Kaplan-Meier模型及Log-rank检验,多因素分析采用COX比例风险模型。结果原发性肝癌RFA治疗后半年、1年、2年、3年的生存率分别为：91．5％、77．4％、55．7％、51．2％。分析可能影响生存期的24项单因素中8项有统计学意义,分别为：肝功能Child-Pugh分级、肿瘤国际抗癌联盟（UICC）分期、初次RFA前甲胎蛋白（AFP）值、门静脉高压、肿瘤复发性、病理分级、治疗目的方案、消融安全范围。根据UICC分期标准,首发癌116例半年、1年、2年、3年的生存率分别为：Ⅰ期和Ⅱ期（33例）达96．7％、92．3％、81．6％、65．3％;Ⅲ期和Ⅳ期（83例）为91．2％、76．3％、56．6％、51．4％;Ⅰ和Ⅱ期与Ⅲ和Ⅳ期之间差异有统计学意义。复发癌56例的生存率分别为88．5％、70．2％、41．4％、24．5％,与首发癌Ⅲ和Ⅳ期差异无统计学意义。与生存率相关的多因素有3项,分别为：Child-Pugh分级、门脉高压、治疗目的方案。结论影响原发性肝癌RFA治疗预后的因素可分为两个方面：患者因素为肝功能Child-Pugh分级、门脉高压程度;治疗方面因素为治疗目的方案;此结果有助于指导RFA治疗。     

Preliminary study on proteomics of gastric carcinoma and its clinical significance

AIM: To explore the preliminary identification of serum protein pattern models that may be novel potential biomarkers in the detection of gastric cancer. METHODS: A total of 130 serum samples, including 70 from patients with gastric cancer and 60 from healthy adults, were detected by surface-enhanced laser desorption and ionization time-of-flight mass spectrometry (SELDI-TOF-MS). The data of spectra were analyzed by Biomarker Patterns Software (BPS). Thirty serum samples of gastric cancer patients and 30 serum samples of healthy adults were grouped into the training group to build models, and the other 70 samples were used to test and evaluate the models. The samples of the test group were judged only with their peaks' height and were separated into cancer group or healthy control group by BPS automatically and the judgments were checked with the histopathologic diagnosis of the samples. RESULTS: Sixteen mass peaks were found to be potential biomarkers with a significant level of P<0.01. Among them, nine mass peaks showed increased expression in patients with gastric cancer. Analyzed by BPS, two peaks were chosen to build the model for gastric cancer detection. The sensitivity, specificity, and accuracy of the model were 90%, 36/40, 86.7%, 26/30, and 88.6%, 62/70, respectively, which were greatly higher than those of clinically used serum biomarkers CEA (carcinoembryonic antigen), CA19-9 and CA72-4. Stage I/II gastric cancer samples of the test group were all judged correctly. CONCLUSION: The novel biomarkers in serum and the established model could be potentially used in the detection of gastric cancer. However, large-scale studies should be carried on to further explore the clinical impact on the model.     

95例乳腺癌保乳治疗近期观察

目的探讨乳腺癌保乳治疗的方法与疗效。方法95例Ⅰ-Ⅱ期原发性乳腺癌,施行局部扩大切除并腋窝淋巴结清扫,手术后患侧乳房接受放射治疗。结果手术后6个月随访,患者本人对保留乳房的满意率100％,十分满意者为92％。经随访2～51个月,平均随访17个月,仅1例同侧乳腺局部复发,2年局部复发率1．4％。无远处转移和死亡病例。结论Ⅰ-Ⅱ期乳腺癌实施保乳治疗,近期疗效满意,远期效果有待长期随访观察。     

Inhibitory effect of retroviral vector containing anti-sense Smad4 gene on Ito cell line, LI90

Background Transforming growth factor-β1 (TGF-β1) exerts strong fibrogenic potential in culture-activated HSCs. Smad4 is a key intracellular mediator for the transforming growth factor-β (TGF-β) superfamily of growth factors. The aim of this study was to assess the effects of the antisense Smad4 gene on Ito cell line, LI90.Methods The recombinant retroviral vector pLXSN-Smad4 was constructed by cloning the rat antisense Smad4 cDNA into the retroviral vector pLXSN. Retroviruses with or without the antisense gene were obtained by transfecting pLXSN-Smad4 and pLXSN vectors into PA317 cells. Human hepatic stellate cells (HSCs) LI90 were infected with these retroviruses followed by selection with G418. The expression of Smad4 was detected by Northern and Western blots. Cell biological characteristics, including cell growth curve, 3H-TdR and 3H-proline uptake by HSCs and the production of extracellular matrix were assessed.Results mRNA and protein expressions of Smad4 in LI90 cells transfected with retrovirus containing the antisense Smad4 gene were much lower than those in LI90 cells transfected with empty vector or parental LI90 cells. Cells hypoexpressing the Smad4 gene exhibited a slower rate of growth, a lower uptake of 3H-TdR and 3H-proline (P&lt;0.01), and smaller production of th extracellular matrix, compared with parental LI90 cells and cells transfected with empty retrovirus.Conclusions The antisense Smad4 gene can suppress the expression of the Smad4 gene, reduce endogenous production of Smad4 mRNA and protein, block TGF-β1 signaling pathway, inhibit activation of Ito cells, obstruct the growth of Ito cells, decrease the production of the extracellular matrix （ECM）. Our results may provide a basis for the development of antifibrotic gene therapy.     

转乳期婴儿不同喂养方式对其碘营养变化的影响

目的了解母乳喂养婴儿及其乳母碘营养水平;动态观察从1个月月龄至6个月月龄转乳期时不同喂养方式对婴儿碘营养的影响.方法对97名1个月月龄母乳喂养婴儿尿碘水平进行测定,同时检测其乳母乳碘、尿碘水平,比较二者关系;动态观察97名婴儿从出生至6个月月龄,按喂养方式分为母乳、混合、人工喂养三组,分别检测比较其尿碘水平,与1个月月龄时尿碘水平进行自身对照比较.结果 1个月月龄母乳喂养婴儿尿碘中位数为183 μg/L,提示碘营养状态良好,乳母尿碘、乳碘中位数分别为122 μg/L、201 μg/L,前者明显低于后者(P＜0.001);6个月月龄尿碘水平与1个月月龄比较,母乳喂养组较前升高,人工喂养组下降(P均<0.001),混合喂养组无明显变化(P＞0.05),3组间差异有显著意义(P＜0.005),母乳及混合喂养组明显高于人工喂养(P均<0.001),母乳喂养组婴儿尿碘中位数最高.结论母乳喂养儿碘营养状态良好,乳母碘营养不足;转乳期婴儿碘营养呈下降趋势,部分人工喂养婴儿存在碘营养不良.     

Relationship among CEA expression in tumor,CEA serum level and radioimmunoguided surgery in colorectal cancer

Current chemotherapeutic agents offer <20% of survival benefits, and surgery still plays an important role in treating colorectal cancer[1]. Although more than two-thirds of patients are candidates for curative surgery, local recurrence occurs in as many as 40% after curative resection[2]. Consequently, a diagnostic tool to enable accurate tumor localization is urgently needed to allow precise and complete removal. Radioimmunoguided surgery (RIGS), originally designed by Aitken, et al.[3], i…     

Effect of body mass index on colorectal cancer

Objective: To evaluate the association between obesity and the risk of colorectal cancer. Methods: 331 patients with rectal cancer and 175 with colon cancer who accepted surgical operation at Beijing Cancer Hospital during 1995 and 2002 were enrolled. Data were collected by reviewing the pathology materials and hospital records. 258 healthy people who accepted health examination at Beijing Cancer Hospital during 2000 and 2002 were also enrolled as control. Data of height, weight and gender at the time of examination were also collected. Obesity was estimated by body mass index (BMI), computed as weight in kilograms divided by height in meters squared (kg/m^2). The degree of obesity was compared between the two groups using BMI≤18.5, 24-27.9 and ≥28 (kg/m^2) as the cut-off points for underweight, overweight and obesity. Associations with obesity were estimated by odds ratios (ORs) and 95% confidence intervals (CIs). All ORs were adjusted for age and sex. Results: Obesity was significantly prevalent in female patients with rectal cancer. All the patients with colon cancer showed lower level of BMI than control subjects. The ORs for rectal cancer rose with increasing BMI in women. Meanwhile, the ORs for colon cancer dropped with increasing BMI in both men and women.Obesity was an independent risk factor for rectal cancer,but not an independent risk factor for colon cancer.Conclusion: Rectal cancer and colon cancer may have different biological behavior. Obese women have relatively high risk for rectal cancer.