结肠肝曲癌侵犯十二指肠的外科治疗

目的:探讨结肠肝曲癌侵犯十二指肠的外科治疗。方法:对1996年1月—2006年8月12例结肠肝曲癌侵犯十二指肠的临床资料进行回顾性分析。结果:结肠肝曲癌侵犯十二指肠程度分两种类型:Ⅰ型局部浸润型,Ⅱ型广泛浸润型或癌性穿孔并内瘘形成。本组12例均行手术治疗,分别采取姑息性手术2例,右半结肠连同十二指肠浸润灶局部切除9例,右半结肠连同十二指肠节段性切除1例．十二指肠缺损单纯修补6例,十二指肠、空肠Roux-en-Y吻合术4例。术后无肠瘘及十二指肠梗阻等并发症。结论:根据结肠肝曲癌侵犯十二指肠不同特点,采取积极合理的手术方式有助于改善病情或减少术后并发症。     

Non-steroidal anti-inflammatory drug (NSAID)-induced colonic strictures and perforation: A case report

Although non-steroidal anti-inflammatory drug-induced colopathy is well described, colonic perforations complicating non-steroidal anti-inflammatory drug intake are rare. We report a patient with rheumatoid arthritis who was on long-term diclofenac and presented with early colonic stricture formation and a caecal perforation, which to the best of our knowledge, has only been reported once before. It is important to suspect this diagnosis in patients on non-steroidal anti-inflammatory drug therapy who present with an acute abdomen.     

大肠癌手术前后血清CA199和CEA水平变化临床价值的研究

目的:研究大肠癌患者手术前后(包括根治术及姑息手术)血清CA199和CEA水平的变化.并探讨其应用价值。方法:应用全自动化学发光免疫分析法,分别测定临床确诊的50例大肠癌患者(术前和手术30 d后)及50例正常成人血清CA199与CEA含量变化。结果:50例大肠癌患者手术前后血清CA199和CEA检测显示,术前血清CA199和CEA均高于对照组(P<0.01),术后血清CEA较CA199下降快,而且大肠癌患者术前血清CA199和CEA含量较根治术30 d后有明显增加,差异有统计学意义(P<0.05)。而姑息性切除手术前后血清CA199和CEA含量变化不大(P>0.05),差异无统计学意义。结论:大肠癌患者术前血青CA199和CEA含量显著增高.而根治术后血清CA199和CEA均有较明显下降。因此,术后定期联合监测血清CA199和CEA有利于临床观察大肠癌患者病情变化,评价手术效果,预测首程化疗疗效,为判断预后、及早发现术后复发病人提供依据。     

丁酸对人结肠癌细胞株SW1116增殖及分化状态的影响

目的:探讨结肠中膳食纤维的酵解产物丁酸对人结肠癌细胞株生长、增殖及分化状态的影响。方法:将传代人结肠癌SW1116细胞株接种于不含及合不同浓度(2、3、4、7、10 mmol/L)丁酸的培养基中。经6、24、48和72h后,用四唑蓝(MTT)法测定细胞增殖率、细胞匀浆中癌胚抗原(CEA)及和碱性磷酸酶(ALP)的表达;同时用电镜观察细胞形态的改变。结果:丁酸对SW1116细胞株的生长抑制作用呈浓度依赖性,在所观察的丁酸浓度及时限内,最高抑制率达53.9％。同时丁酸能大大增加SW1116细胞CEA和ALP的表达;当丁酸浓度≥7mmol/L和培养时间≥48h时,二者增加最为显著(P<0.001)。电镜显示丁酸能使细胞表面微绒毛明显增多。结论:丁酸能抑制SW1116细胞株的生长并诱导其分化。     

Foetal radiation dose in radiotherapy for breast cancer

Management of breast cancer during pregnancy is complicated by the high risks of abortion and foetal malformation from the use of radio therapy and chemotherapy. A case of breast cancer during pregnancy, treated with radiotherapy, and the estimated foetal dose is reported.     

大肠癌病人血清胃泌素水平变化及其意义

采用放射免疫方法测定了３１例大肠癌、１３例非肿瘤者血清标本和２０例大肠癌组织、邻近肿瘤（〈３ｃｍ）及远离肿瘤（５ｃｍ）之结肠粘膜组织匀浆标本中的胃泌素浓度。发现：Ｄｕｋｅｓ Ｃ．Ｄ期大肠癌病人血清胃泌素显著高于非肿瘤者（Ｐ〈０．０５）；血清胃泌素浓度与病程进展呈显著正相关（Ｐ〈０．０５）；直肠癌病人血清胃泌素显著高于非肿瘤（Ｐ〈０．０５）；血清胃泌素水平与肿瘤分化程度无关；肿瘤切除后血清胃泌素显著     

常见肿瘤患者血清维生素A,E,C水平

本文报告２６０例恶性肿瘤患者血清维生素Ａ、Ｅ、Ｃ水平的测定结果。发现除慢性白血病外，蓁７种恶性肿瘤患者血清维生素Ａ水平平均显著低于健康人（Ｐ＜０．０１）；急性白血，肝癌、食管癌患者血清维生素Ｅ水平显著低于健康人（Ｐ＜０．０５）；急性粒细胞白血病、急性单核细胞白血病、肝癌患者血维生素Ｃ水平显著低于健康人（Ｐ＜０．０１）。本研究工作为维生素Ａ、Ｅ、Ｃ药物在肿瘤临床上的应用提供了参考。     

Quality of life in adult survivors of lung,colon and prostate cancer

In a cross-sectional study design, a disease free sample of 57 lung, 117 colon, and 104 prostate cancer survivors who represented short, intermediate and long-term survivors completed a detailed assessment of quality of life (QOL) and rehabilitation needs using the CAncer Rehabilitation Evaluation System (CARES). Demographic and medical data, social support, and a global QOL rating were also assessed. Lung cancer patients showed no differences in QOL with respect to their period of survival. QOL improved for survivors of colon cancer as they lived for longer periods, but declined with time for survivors of prostate cancer. The best predictor of QOL for all groups was KPS, although other variables such as type of hospital, gender, and work status were predictive for survivors of colon cancer. For survivors of prostate cancer comorbidity with other medical illnesses, time since diagnosis and comorbidity due to psychiatric difficulties were predictive of QOL. All groups had significant rehabilitation problems in the domains of physical, psychosocial, sexual, medical interaction, and marital relationships. Lung cancer survivors had more problems than the other cancer survivors. We conclude that patients who survive cancer do not return to a state of normal health. They demonstrate a variety of difficulties with which they must cope as they continue to survive. Greater efforts need to be made early in diagnosis and treatment to understand rehabilitation problems and target interventions in the hope of reducing later sequelae.Currently in private practice, Glendale, CaliforniaC. A. C. Schag was supported in part by Veterans Administration Health Research and Development Grant 83-002 and in part by Cares Consultants, 2210 Wilshire Blvd., Suite 359, Santa Monica, CA 90403.Address requests for Information about CARES to: CARES Consultants, 2210 Wilshire Blvd., Suite 359, Santa Monica, CA 90403, USA. Tel: (+1) 310-450-7410; Fax: (+1) 310-399-0016     

原癌基因C－erb B－2蛋白产物在前列腺癌中的表达

应用抗Ｃ－ｅｒｂＢ－２癌蛋白抗体对３０例前列腺癌进行研究，同时选取１０例正常前列腺组织作为对照。结果表明Ｃ－ｅｒｂＢ－２蛋白与肿瘤分化程度有关。并可能对判断其生物学行为，评估预后有重要意义。     

Intraoperative radiotherapy of upper abdominal tumours

Thirty patients with malignant tumours in the upper abdomen underwent surgery and intraoperalive radiation (IORT), using electron beam, to: the surgical bed, residual or unresected tumour. The technical aspects and results of this treatment are described. Renal, adrenal, bile duct and gastrointestinal tumours were treated. along with several other lesions. The surgical procedure consisted in 10 cases simply of exposure of the tumour for IORT and in 20 the tumour was resected. The TORT dose ranged from 10 to: 20 Gv. In 13 patients, external beam radiation was also given to: residual tumour or to: areas of high risk for recurrence. Chemotherapy was given to: 10 patients. Tolerance to: the combined treatment was acceptable; with few complications related to: IORT.The median follow-up and survival time 23 months (range 4-more than 70 months). Local tumour control rate (or tumour stabilisation) is 90%. Distant metastases developed in 19 patients (63%). The actuarial survival rate for the group projected at 70 months (maximum follow-up) is 37%. IORT in useful in the management of tumours arising in the upper abdominal organs, for palliation surgery or when resectability of the tumour is in doubt. Indications for IORT include patients with uncommon tumours of the upper abdomen who are not be candidates for standardised cancer treatment.Presented at the European Congress of Radiology, Vienna, September 15–20,1991