三维适形放疗联合热化疗治疗局部晚期胰腺癌的临床观察

目的 评价三维适形放疗联合热化疗对局部晚期胰腺癌的临床疗效.方法 将2008年6月至2011年6月间本院收治的70例局部晚期胰腺癌患者分为两组:单纯放疗组30例仅采用单纯放疗,综合治疗组40例在放疗同时及以后给予热化疗.放疗采用三维适形放疗,90％ ～ 95％等剂量曲线,单次剂量1.8 ～2.0 Gy,总放射剂量50 ～70 Gy;热化疗自三维适形放疗开始后同步进行,热疗时维持温度41.5 ～43.5℃,每次1h,每周2次,共6次.热疗中同时给予注射用三氧化二砷20mg、重组改构人肿瘤坏死因子1000万U静脉滴注,进行4～6次,或三维适形放疗同时及治疗后给予吉西他滨0.6 ～1.0 g/m2 d1、8静脉滴注;顺铂20～30mg/m2 d1～3静脉滴注,每28天重复一次,总疗程3～6个周期.结果 治疗后3个月综合治疗组总有效率CR+ PR为70.0％(49/70),其中放疗联合化疗组、放疗联合热化疗组有效率分别为56.5％、88.2％,单纯放疗组有效率56.7％.放疗联合热化疗组有效率与放疗联合化疗组、单纯放疗组相比差异均有统计学意义(x2=4.68,4.98,P＜0.05),而后两者比较差异无统计学意义(P＞0.05).全组1年、2年生存率分别为46.8％和20.3％,其中综合组分别为52.4％和26.7％,单纯放疗组分别为42.5％和16.2％,两组1年、2年生存率比较差异均有统计学意义(x2=14.17,P＜0.05;x2 =9.74,P＜0.05),治疗及随访期间未见穿孔、大出血、持续高热等严重并发症.结论 三维适形放疗联合热化疗治疗局部晚期胰腺癌患者近期疗效满意,毒副反应可耐受,且能提高患者生存质量及生存期,是治疗局部晚期胰腺癌较好的方法.     

全程心理护理对单纯性老年性白内障患者术后的影响

目的探讨全程心理护理对单纯性老年性白内障患者术后的影响。方法将79例行超声乳化手术老年性白内障患者,随机分到干预组和对照组,对照组以常规护理,干预组在常规护理的基础上加用全程心理护理。观察术后视力、住院天数、患者满意度及并发症发生率等情况。结果两组患者术后视力、患者住院天数、患者满意度比较差异有统计学意义(P<0.05),两组患者在术后并发症比较上,前房出血及后囊膜破、裂比较差异无统计学意义(P>0.05),角膜水肿及前房渗出比较差异有统计学意义(P<0.05)。结论老年性白内障患者进行全程心理干预,可提高临床疗效,缩短住院日期和减少并发症的发生。     

碘伏用于消毒牙科高速涡轮手机效果的临床观察

材料与方法一、材料配制 2 0 0ｍｇ/Ｌ、2 5 0ｍｇ/Ｌ、30 0ｍｇ/Ｌ、35 0ｍｇ/Ｌ的碘伏液及2‰的消毒灵液分别置于盛有等大棉球的有色瓶中。手机均为刚钻完急慢性牙髓炎或根尖炎患牙的污染国产手机。增菌培养基及中国兰血平板 :由本院检验科提供。二、方法首先对每例试验用手机于消毒前采样送检 (共计 73例 ) ,并随机选取其中 5例打开手机后盖、取出风轮 ,采手机内部样本送检 ,再做如下试验 :1.不同浓度的碘伏在不同时间内对污染手机表面消毒效果的测定 (共 48例 )用备好的 2 0 0ｍｇ/Ｌ、2 5 0ｍｇ/Ｌ、30 0ｍｇ/Ｌ、35ｍｇ/Ｌ碘伏分别在 …     

前列腺干细胞抗原在胰腺癌神经浸润转移中作用的研究

目的探讨前列腺干细胞抗原（PSCA）在人胰腺癌神经浸润中的作用。方法80例胰腺癌手术标本切片HE染色,观察记数小血管、小淋巴管、神经纤维浸润数。用鼠抗人PSCA单抗行免疫组化二步法染色,观察肿瘤细胞的阳性情况。结果肿瘤细胞神经浸润阳性与小血管、小淋巴管的浸润呈正相关（r=0．978,r=0．548,P〈0．01或P〈0．05）;肿瘤细胞PSCA表达阳性（53例）与神经浸润阳性（66例）呈正相关（r=0．746,P〈0．01）;肿瘤的恶性程度与PSCA表达呈正相关;PSCA表达与小血管、小淋巴管浸润无关。结论PSCA可能是胰腺癌的特征性分子之一。它可引导胰腺癌细胞向神经纤维趋化和黏附,即起“导航”和“停泊”作用。     

碘伏对牙科高速涡轮手机的腐蚀性观察

目的 评价碘伏对牙科高速涡轮手机的腐蚀性。方法 采用肉眼和扫描电镜（ＥＰＭＡ－８７０电子探针）,观察用碘伏及消毒灵分别浸泡手机轴承钢珠、轴砂内部非金属材料和手术刀片后不同时间的表面腐蚀情况。结果 碘伏对金属腐蚀性很小,非金属材料无影响。结论采用碘伏用擦拭法或联合消毒法消毒手机,对手机损伤小。     

1例罕见的猛性龋临床原因分析

猛性龋在危重患者、放疗和化疗的患者中较常见 ,正常人罕见。笔者遇 1例 ,报道如下 :1　临床资料患者女 ,2 3岁 ,在校大学生。因全口牙龋坏影响进食和美观 ,于 2 0 0 0 - 11- 2 1就诊。两年前上颌前牙发黑逐渐龋坏致牙冠缺失 ,残留牙根未行处理而做 11、12、2 1、2 2活动义齿修复。后再诊治时病情加重 ,其余牙 2年内迅速发生龋坏。检查 :11、12、13、14、15、17、2 1、2 2、2 3、2 4、2 6、35、36、43、45、46、47残根 ,16、2 5、2 7、34、37、44残冠 ,死髓牙 ,有部分银汞合金充填物。 31、32、33、41、42近远中邻面均有面积大小不等的龋坏 …     

氢氧化钙甘油在根尖诱导成形术中的疗效

氢氧化钙甘油在根尖诱导成形术中的疗效陈希平张光诚李启艳氢氧化钙是牙根尖成形术的常用药物，本文选用氢氧化钙甘油进行临床观察。１材料和方法１．１病例选择随机选择我院口腔内科门诊因各种原因致牙髓坏死根尖未发育完成的患者２８人，年龄９～４８岁，平均年龄１６．...     

前列腺干细胞抗原在人胰腺癌神经浸润转移中作用的研究

目的探讨前列腺干细胞抗原(PSCA)在人胰腺癌神经浸润中的作用.方法80例胰腺癌手术标本切片行HE染色,观察记数小血管、小淋巴管、神经纤维浸润数.用鼠抗人PSCA单抗行免疫组化(Elivison二步法)染色,观察肿瘤细胞的阳性情况.结果肿瘤细胞神经浸润阳性与小血管、小淋巴管的浸润呈正相关(P<0.01);肿瘤细胞PSCA表达阳性(53例)与神经浸润阳性(66例)呈正相关(P<0.01);肿瘤的恶性程度与PSCA表达呈正相关;PSCA表达与小血管、小淋巴管浸润无关.结论PSCA可能是胰腺癌的特征性分子之一,可引导胰腺癌细胞向神经纤维趋化和黏附,即起"导航"和"停泊"作用.     

神经生长因子及其受体在人胰腺导管癌组织中的表达

Objective To investigate nerve growth factor (β-NGF) and its receptors expression in human pancreatic ductal adenocarcinoma. Methods Expression and distribution of β-NGF, tyrosine kinase A (TrKA) and P75NGFR were detected in operation tissue specimens of pancreatic ductal adenocarcinoma with immunohistochemistry and real-time PCR. Relations of β-NGF and its receptors with clinicalpathological characters, especially nerve invasion were analyzed. Results β-NGF and TrKA expression are higher in pancreatic adenocarcinoma than normal pancreas, and the differences are significant (P < 0. 01). Β-NGF and TrKA expression are associated with the differentiation grades(DG), lymphatic node metastasis, nerve invasion and surgical pathological stages. Poorer of DG and later stages, more expression of β-NGF and TrKA. Β-NGF and TrKA expression have positive correlations. Β-NGF, TrKA and P75NGFR mRNA expression have significantly increased 3.84,4. 23 and 2. 41 times than normal tissues by real-time PCR, respectively. Conclusions β-NGF and TrKA might play potential rules in carcinogenesis for pancreatic cancer,have affinity with clinicopathological characters of pancreatic cancer. Β-NGF and TrKA may have mutual effect in signal transduction leading to perineural invasion of pancreatic carcinoma.     

神经生长因子及其受体在人胰腺导管癌组织中的表达

Objective To investigate nerve growth factor (β-NGF) and its receptors expression in human pancreatic ductal adenocarcinoma. Methods Expression and distribution of β-NGF, tyrosine kinase A (TrKA) and P75NGFR were detected in operation tissue specimens of pancreatic ductal adenocarcinoma with immunohistochemistry and real-time PCR. Relations of β-NGF and its receptors with clinicalpathological characters, especially nerve invasion were analyzed. Results β-NGF and TrKA expression are higher in pancreatic adenocarcinoma than normal pancreas, and the differences are significant (P < 0. 01). Β-NGF and TrKA expression are associated with the differentiation grades(DG), lymphatic node metastasis, nerve invasion and surgical pathological stages. Poorer of DG and later stages, more expression of β-NGF and TrKA. Β-NGF and TrKA expression have positive correlations. Β-NGF, TrKA and P75NGFR mRNA expression have significantly increased 3.84,4. 23 and 2. 41 times than normal tissues by real-time PCR, respectively. Conclusions β-NGF and TrKA might play potential rules in carcinogenesis for pancreatic cancer,have affinity with clinicopathological characters of pancreatic cancer. Β-NGF and TrKA may have mutual effect in signal transduction leading to perineural invasion of pancreatic carcinoma.