D期前列腺癌药物去势的疗效与AR、PSA的相关性研究

目的:探讨D期前列腺癌(PCa)患者药物去势治疗的效果与雄激素受体(AR)、前列腺特异性抗原(PSA)的相关性。方法:对33例D期PCa患者给予LHRH类似物 抗雄激素药物进行药物去势治疗,结合免疫组化进行统计分析。结果:AR、PSA与癌组织分化程度的之间的差异有统计学意义。Gleason不同评分组间血清PSA水平之间差异有统计学意义(P<0.05),PCa Gleason评分值与原位PSA免疫标记表达呈明显的负相关性(P<0.01);原位PSA免疫标记表达与血清PSA不具有相关性。结论:PCa组织中AR、PSA表达与D期PCa患者行药物去势疗法疗效有密切关系;血清PSA变化是监测PCa肿瘤复发与疗效的可靠瘤标。     

Suppression of the jaw-opening reflex by periaqueductal gray stimulation is decreased by paramedian brainstem lesions

Electrical stimulation of the midbrain periaqueductal gray region (PAG) suppresses the tooth pulp-evoked jaw-opening reflex (TP-JOR). In the present study the pathways that mediate this suppression were investigated by placing brainstem lesions in lightly anesthetized cats. Parasagittal lesions that interrupted the afferent and efferent connections of the medullary and pontine raphe nuclei attenuated (but did not abolish) suppression of the TP-JOR evoked by PAG stimulation. This result provides further evidence that medial brainstem structures partially mediate the effects of PAG stimulation in the trigeminal system.     

前列腺特异性抗原检测在空军干部体检中的作用

目的提高前列腺癌的早期诊断。方法对空军中老年干部体检人群增设前列腺特异性抗原（PSA）检测，PSA异常者采用超声引导下活检，明确病理诊断。结果增设PSA检测后前列腺癌的检出率明显提高。结论在对男性中老年人群体检中，PSA是一重要肿瘤检测指标，应列为常规检查项目之一。     

Die Skelettszintigraphie beim neu diagnostizierten Prostatakarzinom

ZusammenfassungHintergrund Die Indikationsstellung zur Skelettszintigraphie beim neu diagnostizierten, unbehandelten Prostatakarzinom ist kontrovers.Patienten und Methoden In der vorliegenden retrospektiven Studie untersuchten wir 406 Patienten, die unabhängig von PSA-Wert und Histologie eine Staging-Skelettszintigraphie erhielten. Aus dem Patientengut evaluierten wir verschiedene Leitlinien und Empfehlungen bezüglich ihrer Vorhersagekraft. Die Kosten wurden gemäß EBM und GOÄ kalkuliert. Bei der Klassifikation von Skelettmetastasen prüften wir die Einteilungen nach Soloway, Crawford und Rigaud.Ergebnisse Eine positive Skelettszintigraphie im Sinne einer Skelettmetastasierung fanden wir bei 41 (10%) der 406 Patienten. Die Leitlinie der EAU hat sich sowohl hinsichtlich ihrer klinischen Wertigkeit als auch der Kosteneffizienz als wertvollste Empfehlung herausgestellt. Als Klassifikationssystem erwies sich die Rigaud-Klassifikation den anderen Einteilungen überlegen.Schlussfolgerung Gemäß der EAU-Leitlinie 2005 scheint die Skelettszintigraphie bei asymptomatischen Patienten mit einem PSA>20 ng/ml (G1/G2) sowie unabhängig vom PSA-Wert bei einem G3-Karzinom und lokal fortgeschrittenem Tumor indiziert. Als bestes Klassifikationssystem für Skelettmetastasen im Skelettszintigramm erwies sich die Einteilung nach Rigaud.     

中脑导水管周围灰质NO对大鼠血压的影响及其机制探讨

目的 探讨大鼠中脑导水管周围灰质(PAG)NO对血压的影响及作用机制。方法 采用微量注射法，观察大鼠血压的变化，放免法检测Ach含量。结果 PAG内微量注射L-NNA后，大鼠平均动脉压升高，延髓头端腹外侧区(RVLM)内Ach含量增多，且这一升压效应可被PALG内预注L-Arg或RVLM内预注东莨菪碱所阻断。结论PAG内NO可能经RVLM内Ach介导对血压有紧张性抑制作用。     

电刺激大鼠下丘脑弓状核对中脑导水管周围灰质单位放电的影响

用玻璃微电极引导大鼠中脑导水管周围灰质（ＰＡＧ）单位放电。发现：电刺激弓状核（ＡＲＣ）后，在所观察的６４个ＰＡＧ单位中，表现为抑制的有３７个单位，其余单位分别表现为先抑制后兴奋、兴奋和无变化。结果表明，大鼠ＡＲＣ对ＰＡＧ单位活动的调制作用以抑制米。     

Serotonergic projections from the midbrain periaqueductal gray and nucleus raphe dorsalis to the nucleus parafasccicularis of the thalamus

By a double-labeling method combining the retrograde tracing of horseradish peroxidase and the immunocytochemical technique, serotonin-like immunoreactive neurons in the midbrain periaqueductal gray (PAG) and nucleus raphe dorsalis (DR) of the rat were observed to send projection fibers to the nucleus parafascicularis of the thalamus bilaterally with an ipsilateral dominance. These serotonin-containing projecting neurons were observed mainly at the middle-caudal levels of the ventrolateral subdivision of the PAG and less at the middle-rostral levels of the DR.     

Imaging of shifted stimulated echoes and multiple spin echoes

It is shown that a repetitive pulse sequence consisting of two 90° pulses and gradients in a 1:2 ratio around the second 90° pulse generates interscan shifted stimulated echoes (SSTEs) and intrascan multiple spin echoes (MSEs). Separation of these two types of signals is accomplished using specific gradient crusher schemes. The intensity of the SSTEs is an order of magnitude larger than that of the MSEs and determines the signal contrast if both effects are selected simultaneously. The SSTE sequence generates improved contrast between gray and white matter, even at high field, which is explained in terms of increased inverse T₁-weighting for the interscan echo. The MSE image has low signal to noise and no detectable contrast. The effect of interscan diffusion weighting is also discussed.     

Rate of PSA rise predicts metastatic versus local recurrence after definitive radiotherapy

: A rising prostate specific antigen (PSA) following treatment for adenocarcinoma of the prostate indicates eventual clinical failure, but the rate of rise can be quite different from patient to patient, as can the pattern of clinical failure. We sought to determine whether the rate of PSA rise could differentiate future local versus metastatistic failure.

: Two thousand six hundred sixty-seven PSA values from 400 patients treated with radiotherapy for localized adenocarcinoma of the prostate were analyzed with respect to PSA patterns and clinical outcome. Patients had received no hormonal therapy or prostate surgey and had ?4 PSA values post-treatment PSA rate of rise, determined by the slope of the natural log, was classified as gradual (< 0.69 log (ng/ml)/year, or doubling time (DT) > 1 year), moderate (0.69-1.4 log (ng/ml)/year, or DT 6 months-1 year), or rapid [>1.4 log (ng/ml)/year, or DT < 6 months].

: SIxty-one percent of patients had non-rising PSA following treatment; 25% of patients with rising PSA developed clinical failure, and 93% of patients with clinical failure had rising PSA. The rate of rise discerned different clinical failure patterns. Local failure occurred in 23% of patients with moderate rate of rise versus 7% with gradual rise (p = 0.0001). Metastatic disease developed in 46% of those with rapid versus 8% with moderate rise (p < 0.0001). By multivariate analysis, in addition to rate of rise, PSA nadir and rate of decline predicted local failure; those with post-treatment nadir of 1–4 ng/ml were five times more likely to experience local failure than nadir < 1 ng/ml (p = 0.0002). Rapid rate of rise was the most significant independent predictor of metastastic failure.

: The rate of PSA rise following definitive radiotherapy can predict clinical failure patterns, with a rapidly rising PSA indicating metastatic recurrence and moderately rising PSA local recurrence. This information could potentially dirent therapy; if the rise predicts metastatic failure hormonal therapy could be cosidereed, while aggressive salvage therapy may benefit subclinical local recurrence identified by a moderate rate of PSA rise.     

PSA在前列腺癌疗效监测中的价值

PSA的临床应用已对前列腺癌的诊断起了巨大作用 ,而且PSA在前列腺癌疗效监测中亦是一重要指标。本文分别就前列腺癌根治性切除术 ,放射治疗和雄激素去除治疗后的PSA变化及其监测价值作一综述