Choroid plexus dysmorphism detected by transvaginal sonography: the earliest sign of fetal hydrocephalus.

Fetal intracranial pathology detected in the early second trimester during 1237 transvaginal sonographic scans is presented. In a sharp contrast to simple choroid cysts, which disappear at the end of the second trimester as part of a benign course, gross distortion of the choroid plexus was found to be related to the later diagnosis of hydrocephalus. Three patterns of this abnormality are early absence of the plexus, hypoplasia and shrinkage, and "Swiss cheese" appearance. Ventriculomegaly in hydropic fetuses does not distort the normal architecture of the choroid plexus. Certain abnormal features of the choroid plexus, observed as early as the 14th week, menstrual age, are landmarks of developing hydrocephalus, currently detectable only later in pregnancy.     

血管能抑素重组基因表达载体抗肺癌效应研究

目的:通过构建人血管能抑制素(Canstatin)真核表达载体,转染裸鼠肿瘤局部,探索其对肺癌治疗作用.方法:RT-PCR法获取Canstatin cDNA全长,定向克隆法构建Canstatin基因表达载体pCMV-Script-Cans.荧光定量PCR法检测转染细胞Canstatin mRNA的表达.台盼蓝拒染法、3H-TdR掺入法检测细胞生长增殖,TUNEL法检测细胞凋亡.基因枪转染重组载体到荷瘤裸鼠肿瘤局部,CD31单克隆抗体微血管记数检测抗血管生成效应.结果:成功构建pCMV-Script-Cans重组载体,并在转染的细胞株中检测到Canstatin mRNA的表达.人脐静脉内皮HUV-EC-C细胞株pCMV-Script-Cans质粒转染组比空载体组3H-TdR掺入量明显减低(P＜0.01),细胞凋亡率明显增加(P＜0.01),重组载体转染肿瘤生长缓慢,微血管数显著低于对照组(P＜0.01).结论:pCMV-Script-Cans重组载体能在转染的哺乳动物细胞中表达Canstatin,并抑制内皮细胞增殖,而且有很好的抗肺癌血管生成作用.     

三维适形低分割放射治疗110例非小细胞肺癌

[目的]探讨非小细胞肺癌(NSCLC)三维适形低分割放射治疗(3D-CHRT)的疗效和有关影响因素.[方法]110例因内科或外科原因不能手术或患者不同意手术非小细胞肺癌,采用美国Varian 6MeV直线加速器,美国Renderplan三维治疗计划系统,单次剂量5Gy～10Gy(中位剂量6Gy),总剂量30Gy～48Gy(中位剂量40Gy).[结果]获CR 62例,PR 38例,NC 7例和PD 3例,总有效率为89.1%,1年生存率74.5%,严重并发症为大咳血(3例).[结论]立体定向适形放射治疗是NSCLC的有效治疗方法.影响治疗效果的主要因素是期别、病理类型和肿瘤大小.Ⅰ、Ⅱ期的鳞癌,肿瘤长径小者疗效较好;单次大剂量照射易引起严重并发症.     

胃肠道恶性肿瘤t-PA、u-PA转录的临床研究

目的：研究胃肠道恶性肿瘤患者纤溶分子标志物血浆含量、mRNA水平的变化，初步探讨两者与肿瘤浸润、播散的关系及其临床检测意义。方法：采用逆转录、实时定量PCR技术检测23例胃癌、17例肠癌患者组织中组织型纤溶酶原激活剂(t—PA)、尿激酶型纤溶酶原激活剂(u—PA)mRNA水平；用ELISA法同步检测患者血浆纤溶分子标志物含量，包括t—PA、u—PA、尿激酶型纤溶酶原激活剂受体(u—PAR)、纤溶酶—抗纤溶酶复合物(PAP)等。结果：胃癌、肠癌组患者血浆u—PA、u—PAR、PAP蛋白含量均较正常对照明显升高，其中，有局部浸润、淋巴结转移、远处脏器转移者u一：PA升高更为显著；t—PA含量与正常对照无显著差异。u—PAmRNA在两种肿瘤细胞表达均显著增高，而t—PAmRNA则减少。结论：纤溶功能亢进是胃肠道恶性肿瘤细胞易播散、浸润的主要原因之一。t—PAmRNA水平的升高可能为组织分化较好的特征。     

立体定向适形放疗剂量对晚期胆管癌治疗疗效的影响

目的：探讨立体定向适形放疗(3D-CRT)剂量对不可切除的胆管癌治疗疗效的影响。方法：对48例不能手术切除的局部晚期胆管癌患者采用3D-CRT技术，根据放疗剂量分为3组，低剂量组12例，DT33～39Gy，中等剂量组23例，DT40—58Gy，高剂量组13例，DT59．4—68Gy。低剂量组3Gy／次，中等剂量组及高剂量组1．8—2．0Gy／次，5次／周。结果：所有患者局部复发的中位时间是10月，中位总生存期是12月。影像学显示24例(50％)疾病进展，其中21例(87．5％)以局部复发作为疾病进展的第一影像学证据，其余3例出现远处转移。3组间局部复发时间(P=0．220)及中位生存时间(P=0．232)差异无显著性。急性胃肠道反应发生率在各放疗剂量组差异无显著性(P=0．485)。结论：局部进展是本组胆管癌治疗失败的主要原因。虽然因本研究病例数较少不足以进到统计处理，但高放疗剂量组具有局部控制率较高、总生存期较长的趋势。     

Quantitative Detection of Interleukin 8 Gene Expression in Lung Cancer by Real-time Polymerase Chain Reaction

Objective To develop a method for absolute quantification of interleukin 8 (IL—8) mRNA by using real-time polymerase chain reaction (PCR). Methods The IL —8 mRNA and protein expression in 2 human lung cancer cell lines, H460 and A549, were evaluated by real-time PCR and ELISA. The IL-8 mRNA expression in 9 cases of normal lung tissue and 44 cases of non-small cell lung cancer (NSCLC) were examined. Results The IL—8 mRNA copy number in a given sample can be measured by real-time PCR. The gene expression of IL—8 is correlated with its protein secretion. The normalized value of IL—8 expression was 4.87±1.69 (copies/ 10⁴ GAPDH copies) in normal lung tissue and 17.04 ±23.96 in NSCLC, respectively. The difference between these two groups is statistically significant (P=0.002). Using 9.74 and 19.48 as cut-off points for positive expression and overexpression of IL—8, 52.3%(23/44cases) of NSCLC were found to express an increased level of IL-8, among which 29.5% (13/ 44cases) were defined as positive expression and 22.7%(10/44cases) as overexpression. Statistical analysis indicated that IL—8 overexpression was significantly increased in female cancers, squamous carcinoma, and in late stages of disease (P<0.05). Conclusion The IL—8 gene expression can be determined by a real-time PCR technique. IL -8 overexpression is correlated with gender, histopathology and stages of the disease.     

胸段食管癌三维适形放疗摆位误差研究

Objective To study the setup errors in three-dimensional conformal radiotherapy (3DCRT) for thoracic esophageal carcinoma using electronic portal imaging device(EPID) and calculate the margins from CTV to PTV. Methods Forty-one patients with thoracic esophageal carcinoma who received 3DCRT were continuously enrolled into this study. The anterior and lateral electronic portal images (EPI) were aquired by EPID once a week. The setup errors were obtained through comparing the difference between EPI and digitally reconstructed radiographs(DRR). Then the setup margins from CTV to PTV were calculat-ed. By using self paired design,22 patients received definitive radiotherapy with different margins. Group A: the margins were 10 mm in all the three axes;Group B: the margins were aquired in this study. The differ-ence were compared by Paired t-test or Wilcoxon signed-rank test. Results The margins from CTV to PTV in x,y and z axes were 8.72 mm, 10.50 mm and 5.62 mm, respectively. Between the group A and group B, the difference of the maximum dose of the spinal cord was significant(4638.7 cGy±1449.6 cGy vs. 4310.2 cGy±1528.7 cGy; t=5.48, P=0.000), and the difference of NTCP for the spinal cord was also significant (4.82%±5.99% vs. 3.64%±4.70%;Z=-2.70,P=0.007). Conclusions For patients with tho-racic esophageal carcinoma who receive 3DCRT in author's department,the margins from CTV to PTV in x, y and z axes were 8.72 mm, 10.50 mm and 5.62 mm, respectively. The spinal cord could be better protected by using these setup margins than using 10 mm in each axis.     

未破裂型输卵管妊娠136例阴道超声声像分析

目的 探讨未破裂型输卵管妊娠阴道超声声像特征及误诊原因。方法 回顾性分析经临床和病理对比的136例未破裂型输卵管妊娠病例的F)1道超声声像特征。结果 宫外胚囊声像35例，卵巢旁小包块58例，盆腔一侧橄榄形或管状包块43例，误诊5例。结论 未破裂型输卵管妊娠阴道超声声像有一定特征，其共性为卵巢旁境界清晰，形态规则不均质包块。     

Diagnosis of ectopic pregnancy after in vitro fertilization and embryo transfer

Objective: The combination of transvaginal sonography and serum hCG measurement is reliable in the diagnosis of ectopic pregnancy (EP) in spontaneous pregnancies. In patients who became pregnant through IVF-ET, transfer of multiple embryos after IVF could be responsible for the different performance of these tests. We evaluated the discriminative capacity of transvaginal sonography in combination with hCG measurement in the diagnosis of EP after IVF-ET.

Design: Prospective cohort study.

Setting and Patient(s): Consecutive patients, pregnant through IVF-ET, who presented with clinically suspected EP.

Intervention(s): Transvaginal sonography, serum hCG measurement at 6, 9, and 15 days after ET and after a negative transvaginal sonography.

Main Outcome Measure(s): Ectopic pregnancy confirmed at laparoscopy.

Result(s): Between September 1993 and May 1996, 86 women were included in the study, of whom 24 had an EP. Transvaginal sonography identified 46 intrauterine pregnancies and 5 EPs, but serum hCG could not diagnose EPs in patients in whom transvaginal sonography did not show a gestational sac. Serum hCG measurement 9 days after ET could identify pregnancy failure with 100% specificity at a cut-off value of 18 IU/L, but it could not identify patients with EP with enough certainty to justify immediate treatment.

Conclusion(s): We recommend single serum hCG measurement 9 days after ET to discriminate between viable and nonviable pregnancies. Transvaginal sonography can be postponed until 5 weeks after ET, except for patients with abdominal pain and/or vaginal bleeding, or patients with a serum hCG level of <18 IU/L.     

Construction and analysis of three-dimensional graphic model of single-chain Fv derived from an anti-human placental acidic isoferritin monoclonal antibody by computer

As a 24--iner consisting of different proportions of two main subunit types, named L and H,ferritin is a protein involved in iron storage. Inmammalian tissues, ferritin exists in differentmolecular forms (isoferritins )LI,2]. Previous studies showed that the acidic isoform of ferritin existing in the placenta, fetal tissues and malignant tissues was abnormally increased in the sera of patients with malignancies as well as in pregnantwomen at risk of having small--for--gestational ageinfants[3…