超声刀在小切口机械悬吊腔镜辅助下甲状腺手术中的应用体会

目的观察超声刀在小切口机械悬吊腔镜辅助下甲状腺手术（Miccoli手术）应用的效果。方法对28例甲状腺疾病患者在Miccoli手术中使用超声刀。结果28例完成Miccoli手术，平均出血量8m1（5—10m1），术后切口引流仅有少量渗湿，纱布（覆盖切口纱布为8层）渗湿面积平均2cm^2（1～5cm^2），无神经损伤，无甲状旁腺损伤。结论超声刀能保证Miccoli手术顺利完成，止血效果可靠，使用方便，安全。     

三阴性乳腺癌中CK5/6和PTEN的表达及其临床病理意义

[摘要]　目的　探讨三阴性乳腺癌组织中CK5/6和PTEN的表达及其临床病理意义。　方法　　通过免疫组化方法检测68例三阴性乳腺癌组织和22例正常乳腺组织CK5/6和PTEN的表达,分析两者的表达水平与临床病理特征及预后的关系。　结果　CK5/6在三阴性乳腺癌组织阳性率为52.9%（36/68）,明显高于正常乳腺组织9.1%（2/22）（P<0.05）。PTEN在三阴性乳腺癌组织阳性率为55.9%（38/68）,明显低于正常乳腺组织90.9%（20/22）（P<0.05）。CK5/6和PTEN表达在肿瘤直径<5 cm和≥5 cm间,淋巴结转移数目<5个和≥5个间及是否远处转移间比较,差异均有显著性意义（P<0.05）。三阴性乳腺癌CK5/6阳性组及PTEN阴性组患者的生存时间显著短于CK5/6阴性组及PTEN阳性组（P<0.05）。　结论　　三阴性乳腺癌CK5/6表达和PTEN表达缺失与肿瘤大小、淋巴结转移数目及远处转移有关,CK5/6表达和PTEN表达缺失提示患者预后不良。     

上调NDRG1表达降低奥沙利铂耐药结肠癌细胞的存活率

目的观察上调NDRG1表达对结肠癌细胞及奥沙利铂耐药结肠癌细胞的毒性作用并探讨其机制。方法以重组真核表达质粒pEGFP-NDRG1-N3转染HCT 116及奥沙利铂耐药的OHP-HCT 116结肠癌细胞,以实时定量(qRT)-PCR法和Western blot法检测转染效率。MTT法检测奥沙利铂对不同结肠癌细胞的毒性及验证OHP-HCT 116细胞的耐药性。给予奥沙利铂干预转染pEGFP-NDRG1-N3的HCT 116细胞及OHP-HCT 116细胞,MTT法检测细胞存活率,流式细胞术检测细胞凋亡率,Western blot法检测凋亡蛋白Bcl-2及p53蛋白水平变化。结果不同浓度奥沙利铂干预下的3株结肠癌细胞中HCT 116细胞对奥沙利铂最敏感,OHP-HCT 116细胞对奥沙利铂耐药得到验证。以不同浓度梯度奥沙利铂干扰转染pEGFP-NDRG1-N3的HCT 116细胞及OHP-HCT 116细胞,与MOCK及siNC组比较,在HCT 116细胞及OHP-HCT 116细胞,转染pEGFP-NDRG1-N3细胞的存活率下降(P<0.05),凋亡率升高(P<0.05),Bcl-2表达降低(P<0.05),p53表达升高(P<0.05)。结论上调NDRG1表达通过调控p53表达改善结肠癌细胞奥沙利铂耐药,提高化疗敏感性。     

影响局部进展期直肠癌新辅助放化疗疗效的临床因素分析

目的探讨影响局部进展期直肠癌(locally advanced rectal cancer,LARC)患者新辅助放化疗(neoadjuvant chemoradiotherapy,nCRT)的疗效及预后的临床因素。方法回顾性分析辽宁省肿瘤医院335例接受nCRT后并进行根治性手术的LARC患者的临床资料。通过单因素及多因素分析,找出可能影响LARC患者nCRT的疗效及预后的临床因素。结果多因素Logistic回归分析表明,影响LARC患者nCRT疗效的独立临床因素有nCRT前肿瘤侵犯肠管周径(OR=2.350,95%CI:1.438~3.842,P=0.01)、cT分期(OR=2.101,95%CI:1.024~4.314,P=0.043)及cN分期(OR=5.836,95%CI:3.305~10.306,P<0.01)。竞争风险模型分析表明,影响LARC患者预后的独立因素有肿瘤退缩分级(tumor regression grading,TRG)的评级(HR=3.236,95%CI:1.714~6.110,P<0.01)、cT分期(HR=1.852,95%CI:1.061~3.230,P=0.030)、cN分期(HR=2.008,95%CI:1.083~0.372,P=0.027)、nCRT前癌胚抗原(carcinoembryonic antigen,CEA)水平(HR=7.038,95%CI:3.894~12.720,P<0.01)及血清糖类抗原199(Carbohydrate antigen 199,CA199)水平(HR=3.849,95%CI:2.016~7.350,P<0.01)。结论nCRT前肿瘤侵犯肠管周径、cT分期及cN分期是影响LARC患者nCRT疗效的独立临床因素,nCRT之前肿瘤侵犯肠管周径越大,cT分期及cN分期越高,LARC患者的nCRT疗效越差。TRG分级、cT分期、cN分期、nCRT前CEA和CA199水平是影响LARC患者预后的独立因素,接受nCRT的LARC患者TRG分级越高,cT分期及cN分期越高,nCRT前CEA及CA199水平越高,其预后可能越差。     

β-catenin，c-myc和Cyclin D1在胰腺癌组织中的表达及意义

目的研究β-catenin异常表达、c-myc和Cyclin D1的高表达与胰腺癌发生、浸润、转移的关系。方法应用免疫组织化学方法检测5例正常胰腺组织和40例胰腺癌及13例相应癌旁组织中β-catenm、c-myc和Cyclin D1的表达。结果 5例正常胰腺组织及13例胰腺癌旁组织中β-catenin为正常表达,c-myc和Cyclin D1阴性表达,40例胰腺癌组织中25例有β-catenin的异常表达(25／40,62．5％),20例(20／40,50％)有c-myc的高表达,23例(23／40,57．5％)有Cyclin D1的高表达。β-catenin的异常表达率与淋巴结转移、浸润及病理分级相关(P<0.05),c-myc和Cyclin D1的高表达与分化程度,浸润,转移及病理分级无关,β-catenin的异常表达与c-myc的阳性表达不相关,而与Cyclin D1的阳性表达相关。结论β-catenin的异常表达可能主要是通过激活Cyclin D1引起细胞增殖,导致肿瘤的发生。     

Transplantation of mobilized peripheral blood mononuclear cells for peripheral arterial occlusive disease of the lower extremity

Introduction Peripheral arterial occlusive disease (PAOD) includes a group of diseases caused by the obstruction of peripheral arteries to the legs, and characterized by local ischemia and necrosis.1, 2 In China, the morbidity and mortality of patients with PAOD has been increasing in recent years, perhaps due to changes in lifestyle of the Chinese people. Although progress has been seen in surgical and interventional tech- niques during the last decades, a substantial number of patients w…     

Anti-inflammatory and antioxidant effects of curcumin on acute lung injury in a rodent model of intestinal ischemia reperfusion by inhibiting the pathway of NF-Kb

Objective: To investigate the anti-inflammatory and antioxidant effect of curcumin on lung lesion induced by intestinal ischemia reperfusion injury (IIR). Methods: Rats were divided into four groups: sham, intestinal IIR (IIR), 1 mg/kg of curcumin treatment group (1 mg/kg), and 5 mg/kg of curcumin treatment group (5 mg/kg). Curcumin was given respectively (1 mg/kg and 5 mg/kg) following the above doses. IIR was produced by 1 h of intestinal ischemia followed by 2 h of reperfusion. Rats were sacrificed at the end of reperfusion and lung tissues were collected for biochemical and histopathological examination in 4 groups. Lung tissues histology and bronchoalveolar lavage fluid (BALF) protein were assayed. Serum IL-6, lung superoxide dismutase (SOD) and myeloperoxidase (MPO) were measured. The expression level of NF-κB and ICAM-1 (including immunohistochemical analysis and western blot analysis) were also measured. Results: Lung tissue injury induced by IIR was obviously observed through pathology and BALF protein. MPO activity, IL-6 level and ICAM-1 expression were significantly increased with the elevation of NF-κB, simultaneously, SOD activity was decreased. With Treatment of curcumin, pathology and BALF protein of lung tissue were improved clearly. Inflammatory indexes (MPO activity, IL-6 level and ICAM-1) were improved and antioxidant index (SOD activity) was enhanced paralleled with NF-κB. Conclusion: Using curcumin effectively prevented IIR-induced lung injury. Anti-inflammatory and antioxidant effects of curcumin could be observed by inhibiting the pathway of NF-κB.     

2015—2017年辽宁省肿瘤医院门诊麻醉药品的使用情况分析

目的 了解并分析2015—2017年辽宁省肿瘤医院门诊麻醉药品的临床应用及用药趋势,评价其合理性,为麻醉药品的规范管理和合理应用提供参考。方法 采用WHO推荐的限定日剂量（DDD）法对2017年2015—2017年辽宁省肿瘤医院门诊麻醉药品的规格、销量、销售金额、用药频度（DDDs）、日均费用（DDC））和排序比（B/A）等进行统计分析。结果 门诊麻醉药品的用量和销售金额逐年上升,结构日趋合理。盐酸羟考酮控释片和硫酸吗啡控释片的用量和DDDs逐年递增;芬太尼透皮贴剂和盐酸吗啡控释片的DDDs排序逐年下降。盐酸羟考酮控释片的DDC值最高,磷酸可待因片、阿片片和盐酸布桂嗪片的DDC值最低。2017年除盐酸吗啡片（30 mg）和盐酸羟考酮控释片（10 mg）外,其他药物的B/A值均接近1.00。结论 辽宁省肿瘤医院门诊麻醉药品的使用情况较为合理,但仍需加强管理。     

7-乙基-10-羟基喜树碱脂质体在大鼠体内的代谢和排泄

目的考察7-乙基-10-羟基喜树碱(SN-38)脂质体经静脉注射后,在大鼠尿液、粪便中的代谢产物以及以SN-38原形药物排泄的量。方法大鼠尾静脉单次给予2.77 mg/kg SN-38脂质体,分别于0～6、6～12、12～24、24～48 h分段收集尿液、粪便,采用UPLC/Q-TOFMS法对SN-38脂质体在大鼠尿液、粪便中的代谢产物进行鉴定,并且建立HPLC法,用于大鼠尿液及粪便样品中SN-38原形药物的排泄量的测定。结果 SN-38脂质体的在大鼠体内的代谢产物经鉴定为SN-38G。48 h内脂质体组共有1.57%的原形药物经过尿液排出,共有12.94%的SN-38原形药物经过粪便排出。结论 SN-38脂质体只有少部分以原形药物经尿液和粪便排出体外。