乳腺癌根治术I期横型腹直肌肌皮瓣乳房再造

乳腺癌是一种严重影响妇女身心健康甚至危及生命的常见病和多发病，其发病率在我国占全身各种恶性肿瘤的7～10％，且发病率逐年上升，呈年轻化趋势。现在，乳腺癌早期诊断病例的增加和综合治疗的进展，患者多能长期生存，甚至获得治愈，乳腺癌是目前临床治疗效果最佳的实体肿瘤之一。根治性手术切除仍是国内治疗乳腺最主要的手段。因此，乳房缺如(全切除)或乳房毁形(部分切除)的病例持续     

芬太尼透皮贴剂治疗中重度癌痛433例临床观察

目的:进一步评价芬太尼透皮贴剂治疗中、重度疼痛的疗效、安全性及对生活质量的影响,为临床合理用药提供参考资料.方法:采用多中心随机开放方法,对433例中、重度疼痛患者使用芬太尼透皮贴剂进行观察,芬太尼的初始剂量是2.5mg或参照吗啡芬太尼折算表计算,贴膜每3日更换1次,在使用期间根据疼痛情况进行剂量调整,直到患者无痛或基本无痛.结果:可评价患者336例,其癌痛缓解率100%,41.6%的患者第1次使用后未再进行剂量调整,57.3%的患者调整过1～3次.芬太尼的中位剂量7.5mg,其中92.9%患者在2.5～10mg之内.不良反应轻,主要为恶心、便秘、头晕、呕吐、嗜睡、排尿困难等.治疗后生活质量有明显改善.结论:芬太尼透皮贴剂治疗中、重度疼痛的疗效显著,使用方便,不良反应轻,能明显改善患者的生活质量,绝大多数患者的调整次数在3次以内,大多数患者的使用剂量在每3天2.5～10mg.     

顺铂腹腔热灌注联合静脉化疗治疗中晚期腹盆腔恶性肿瘤

目的:探讨顺铂腹腔热灌注联合静脉化疗治疗中晚期腹盆腔恶性肿瘤的疗效。方法:经病理组织学或细胞学确诊的Ⅲ期或Ⅳ期患者110例(男63例,女47例)。顺铂50mg/m2加NS1500mL/m2加热至43℃快速注入腹膜腔,CF0.2g/m2静脉滴注第1天~第5天,5蛳Fu500mg/m2行锁骨下静脉穿刺置管应用可控微量泵持续静脉输注24h,第1天~第5天。4周期后评价疗效与毒副反应。结果:97例可评价患者中部分缓解(PR)31例,SD20例,总有效率31.9%(31/97)。结论:顺铂腹腔热灌注联合静脉化疗治疗中晚期腹盆腔恶性肿瘤有效且安全。     

皮肤光老化动物模型的建立

目的:应用中波紫外线(UVB 290-320nm)照射无毛鼠,观察UVB对无毛鼠皮肤纹理、表皮、及真皮基质的影响,建立皮肤光老化动物模型,为临床防治皮肤光老化打下基础。方法:应用皮肤图像分析系统、皮肤组织学及特殊染色方法,对接受中波紫外线照射20周的无毛鼠进行皮肤纹理、表皮、真皮、基底膜、粘多糖、胶原纤维、弹性纤维进行对比观察。结果:无毛鼠经UVB照射20周、总计量5.9J/cm2,皮肤出现粗糙,皮纹加深、加宽。皮肤增厚,表皮增生、伴有角化过度及角化不全。真皮水肿,纤维母细胞增生,弥漫性单核细胞、肥大细胞、嗜中性白细胞侵润。基底膜不规则增厚。胶原含量减少,染色变浅,胶原纤维明显变性,均质化,形成片、块状,变性的胶原纤维延伸至真皮深层。弹性纤维增多变粗,部分增生的弹性纤维聚集、断裂、缠结。结论:中波紫外线引起的皮肤损害是一个慢性炎症过程。真皮及真皮基质的改变是紫外线引起皮肤光老化的病理基础。中波紫外线照射后的无毛鼠的皮肤所发生的变化与临床皮肤光老化疾病一致,因此该模型是较为理想的研究皮肤光老化的动物模型。     

Effects of Imbalance of Apoptosis and Proliferation on Large Bowel Carcinogenesis in Mice

OBJECTIVE To observe the pattern of changes in the proliferation and apoptosis at different stages of large bowel carcinoma in mice, and to explore the effects of the imbalance of apoptosis and proliferation at different stages of large-intestine carcinogenesis.METHODS An experimental animal model for large intestine carcinogenesis of KUNMING-strain mice was used. The carcinomas were induced by subcuteneous injection of dimethylhydrazine (DMH) and the distribution and density changes of proliferating and apoptotic cells observed through multistages toward cancer formation. The animals were killed in groups at the 12th, 18th, 24th,and 32nd weeks of carcinoma induction. The apoptotic and proliferating cells were labeled separately using TUNEL and PCNA immunohistochemical staining methodsRF, RESULTS In the normal mouse mucosa, all the apoptotic cells were situated in the superficial layers, however, the proliferating cells were situated in the basement layers, and the amount of both were small. In the early stage of carcinoma induction, the proliferation and the apoptotic cells slightly increased in amount, but there were no obvious changes in their ratio. In the medium stage, the densities of both distinctly increased, but there were no obvious changes in the ratio. In the late stage, the densities of the proliferating and the apoptotic cells in the non-carcinoma mucosa were higher than those at other stages. The proliferating cells in the dysplastic mucosa increased progressively with the increasing degree of the lesions. Although the apoptotic cells increased, their changes did not occur with the degree of the lesions. Their ratio showed a decreasing tendency with the degree of the lesions.CONCLUSIONS (①The presence of an imbalance between cell proliferation and apoptosis was confirmed in the course of large intestine carcinogenesis in a mouse model. ②In the early stage of carcinoma induction both proliferation and apoptosis were at a low level; in the medium stage, they were both at a high level; and in the late stage (that is in carcinoma), proliferation was at a very high level, while apoptosis was at a low level. ③The proliferating cells increased progressively with the degree of dysplasia. There were no obvious changes in the apoptotic cells and their ratio to the proliferating cell sshowed a progressively increasing tendency. ④In the stage of cancer formation, the most essential change was the excessive decrease in the ratio of apoptosis to proliferation. These results support the hypothesis of “Cell Selective Proliferation“, which was raised by authors previously in a study on human large bowel carcinoma.     

高能聚焦超声刀治疗腹盆腔恶性肿瘤的临床观察

目的探讨高能聚焦超声刀治疗腹盆腔恶性肿瘤的临床疗效。方法93例经病理学或细胞学确诊的腹盆腔恶性肿瘤患者，取侧卧位、俯卧位或坐位用高能聚焦超声刀治疗1～12次，平均5次。结果HIFU治疗实体瘤83例，其中cR18例，PR40例，NR25例，总有效率达70％。治疗空腔脏器肿瘤10例；其中CR4例，PR4例，NR2例，总有效率80％。35例疼痛患者中疼痛症状改善显效11例，有效19例，无效5例，总有效率86％。结论HIFU治疗腹盆腔肿瘤可使恶性肿瘤得到局部控制有效率达到70％～80％，并有明显的止痛作用，改善了患者生存质量，且对身体无明显的副作用，可作为肿瘤综合治疗的一个手段。为那些无法进行手术的中晚期癌症患者和年老体弱其它器官有严重并发症的患者提供了较好的治疗措施。     

动物毒液—新型药源

狼蛛毒液：美国科学家通过动物试验证实从狼蛛（一种蜘蛛）液中提取出的一种化合物能有效缩短心房纤颤的时间。因此它有望被开发成为治疗这类心律失常的新药。从狼蛛毒液中提取出的这种化合物名叫GsMtx-4，是一种小分子肽类物质。在科学家们进行的动物试验中，该物质能有效缩短心房纤颤的时间。研究人员认为，心脏细胞中某些输送钙、钾、钠等离子的特殊通道可能是导致心房纤颤的根源，而GsMtx-4恰好能阻塞这些通道，防止心脏发病。腹蛇毒液：蛇毒是很好的镇痛剂、溶栓剂和止血药，它越来越多地被广泛应用于临床。蛇毒制剂对心脑血管疾病和…     

踝关节骨折经皮复位器的研制及应用

对于踝关节旋后 外旋型 Ⅲ ～ Ⅳ 度骨折 ,临床上常采用手法复位经皮穿针内固定术治疗 ,但由于该骨折部位的局限性和骨折移位的特殊性 ,往往因难以获得满意复位而造成踝关节的结构失常 ,直接地影响着远期疗效。为了提高经皮穿针固定治疗内外踝骨折时的复位效果 ,作者自 2 0 0 1年开始对该类型骨折的移位机理和经皮穿针时骨折复位不良的原因进行了观察、研究 ,并自行设计、研制出一种逆该类型骨折移位机理进行骨折复位的踝关节骨折经皮复位器 (下称经皮复位器 ) ,经临床应用观察 ,效果满意。现介绍如下。1　经皮复位器的构造经皮复位器由河…     

CT引导PLDD治疗腰椎间盘突出症

作者自 2 0 0 1年 2月～ 2 0 0 2年 2月 ,采用在CT引导下经皮激光椎间盘减压术 (PLDD)治疗腰椎间盘突出症 35例 ,取得了满意疗效。现总结报告如下。1　临床资料1.1　一般资料　本组 35例 ,男 2 4例 ,女 11例 ;年龄最大 4 7岁 ,最小 19.5岁 ,平均 31.2岁 ;病程最长 2 .6年 ,最短 0 .5年 ,平均 1.8年 ;腰痛伴下肢疼痛 19例 ,单纯下肢疼痛 16例 ;膝腱反射消失 2例 ,跟腱反射消失 5例 ,拇趾背伸力减弱 12例 ;CT检查示腰椎间盘呈局限性突出于一侧 ,神经根明显受压 ,其中L3～ 4间盘突出 4例 ,L4～ 5间盘突出 18例 ,L5S1间盘突出 13例。1.2　…