赛赓啶对 KBV200细胞多药抗性的逆转作用

研究赛赓啶对KB_V200细胞多药抗性的逆转作用及逆转机制。在KB_V200细胞,采用MTT法,测出赛赓啶对长春新碱、阿霉素和鬼臼乙叉甙耐药的逆转系数分别为5.5,2.0和1.9,而对5-氟尿嘧啶、美法仑的细胞毒性作用无明显影响,表明赛赓啶为多药抗性逆转剂。荧光分光光度法测定表明,赛赓啶可使KB_V200细胞内阿霉素蓄积量增加。流式细胞荧光测定显示赛赓啶可增加罗丹明123的蓄积并减慢其外排。免疫细胞化学及狭缝杂交表明赛赓啶不影响KB_V200细胞的P-糖蛋白染色深度和 mdr1 RNA 表达水平。以上结果提示赛赓啶的多药抗性逆转机制是抑制P-糖蛋白泵的功能。     

Overexpression/amplification of HER-2/neu is uncommon in hepatocellular carcinoma

BACKGROUND： Hepatocellular carcinoma （HCC） is one of the most prevalent fatal cancers in the world. Despite advances in early diagnosis and improvements in surgical techniques, the survival of patients with HCC even after resection is poor because of the high incidence of recurrences. Therefore, the identification of prognostic factors may be helpful in the development of new treatment protocols. AIMS： To investigate HER-2/neu status in HCC by immunohistochemistry （IHC） and fluorescence in situ hybridisation （FISH）, and to explore the possibility of using trastuzumab in the treatment of HCC. METH ODS： Eight hundred and sixty eight surgical samples from patients with primary HCC were examined for their HER-2/neu status. IHC for HER-2/neu was performed with the HercepTest kit; FISH analysis was performed with the PathVysion HER-2 DNA probe kit. The correlations between HER-2/neu overexpression and clinicopathological characteristics were analysed statistically. RESULTS： HER-2/neu overexpression was detected in 21 （2.42%） of the 868 primary HCCs. Only one specimen showed HER-2/neu gene amplification by FISH. No significant associations were found between HER-2/neu overexpression and the clinicopathological parameters. CONCLUSIONS： There is a low frequency of HER-2/neu overexpression/amplification in HCC. There appears to be no role for HER-2/neu as a prognostic marker and no benefit of anti-HER-2/neu trastuzumab treatment in patients with HCC.     

极外型腰椎间盘突出症的临床特点与神经节位置的相关性研究

目的 探 讨极 外 型腰 椎间 盘 突出 症患 者 的临 床特 点 与神 经节 位 置的 相关 性 方 法:通过 术前 神 经根 造影 : 。确定 受压 神 经根 的背 根 神经 节的 位 置,根 据 其神 经节 的 位置 ,将 27 例极 外侧 腰 椎间 盘突 出 症患 者 分为 三 组 :椎管内 组,5 例;椎间 孔内 组 ,15 例 ;椎 间孔 外组 ,7 例 。分 别比 较神 经 节的 位置 与 临床 参数 ,如 受压 神 经根 的水 平 ,直腿 抬高 试 验的 度数 ,术 前和 术 后症 状(腿痛 ,下 腰痛 和 行走 能力 )及 体 征(感 觉 和运 动障 碍 )的 严重 程 度 及 与恢复率 之间 的 关系 。结 果:与椎 管 内和 椎间 孔 内组 相比 ,椎 间孔 外 组患 者直 腿 抬高 试验 的 度数 较低 ,下 腰 痛的 程度较轻 ,术 前的 腿痛 明 显重 ,而 行走 能 力低 于椎 管 内和 椎间 孔 组。 背根 神 经节 的位 置 与术 前的 感 觉和 运 动 障 碍以及手 术效 果 没有 明显 差 异。结论 :神 经节 的 位置 会影 响 极外 型腰 椎 间盘 突出 患 者根 性症 状 (腿痛 和 行走 能力 )的严重 程度 。     

Conservative surgery and radiation therapy in black women with early stage breast cancer. Patterns of failure and analysis of outcome.

Between 1977 and 1986, 75 black and 615 white women with American Joint Committee (AJC) Stages I and II breast cancer were treated with excisional biopsy, axillary dissection, and radiation therapy for breast conservation. Cyclophosphamide, methotrexate, and 5-fluorouracil, with and without prednisone and tamoxifen, was given to 92% of premenopausal, 83% of perimenopausal, and 63% of postmenopausal node-positive women; 20 of 106 (19%) postmenopausal node-positive women received tamoxifen only. The clinical characteristics of the similarly treated patients were compared. The 5-year actuarial local only first failure rate was 5% for black women and 6% for white women (P = 0.53). Regional only failure as the first site of failure was 9% for blacks versus 1% for whites (P = 0.002), with regional recurrence as any component of first failure being 16% for blacks and 4% for whites (P = 0.001). The supraclavicular fossa was identified as the primary site of regional recurrence in black patients with either pathologically positive or negative axillae. Distant metastases as the only site of first failure were significantly greater in the black population with a 20% 5-year actuarial failure rate versus 11% in white patients (P = 0.01). The 5-year actuarial overall survival for the black patients was 82% versus 91% for the white patients (P = 0.01), with no-evidence-of-disease (NED) survival being 64% and 83% (P = 0.0002) and relapse-free survival (RFS) being 61% and 77% (P = 0.01), respectively. Black patients younger than 40 years of age or with pathologically positive axillary nodes had significantly worse NED, RFS, and overall survival compared with similarly staged white patients. Cosmetic results were analyzed at 3 and 5 years after completion of therapy. Although significantly fewer black patients had an excellent-to-good cosmetic result at 3 years compared with white patients, the results were not significantly different at 5 years. These results show that appropriately selected black patients with early stage breast cancer have excellent local control after conservative surgery and radiation therapy and should continue to be offered breast preservation as an alternative to mastectomy. Patterns of failure, however, demonstrated higher regional and distant recurrence rates and lower NED, RFS, and overall survival rates in most subsets of black patients reviewed.     

老年患者不同证型红外热象舌图温度负荷的变化

目的 :探讨老年不同中医辨证分型的红外热象舌图温度负荷变化。方法 :被测试者分为阴虚证、阳虚证、气滞血瘀证、气血两虚证、湿热证五组。施以冷负荷后 ,红外舌图分析选取七个点温为代表 ,以计算机图像处理系统确定纵横坐标位置 ,对采录的所有红外舌图进行分析、处理。结果 :阴虚组舌尖、舌前两侧点冷负荷前后变化值与正常组比较 P<0 .0 5 ;阳虚组各点冷负荷前后变化值均低于正常组 (除 M点 ) ,且 T点、TL 点、TR点、M点均大于气血两虚组及湿热组 P<0 .0 5 ;气滞血瘀组舌温变化值低于正常 (T点 P<0 .0 5 ) ;气血两虚组各点温变化值均显著低于正常组 (P<0 .0 5～ 0 .0 1)及其他证型组 ;湿热组舌尖、舌前两侧点冷负荷前后变化值与正常组比较 P<0 .0 5 ,且低于阴虚组、阳虚组、气滞血瘀组。结论 :老年不同中医辨证分型的红外热象舌图各有其特征 ,红外热象舌图直观、重复性强 ,可作为中医辨证分型和疗效判断的临床指标     

体外循环术后低钾血症370例的护理

1临床资料我院1996-01/2004-12体外循环下行心内直视手术370例,其中先心病240例,冠状动脉搭桥术55例,风心病瓣膜置换术75例,年龄1.5～74.0岁.     

Breast cancer in women after augmentation mammoplasty

More than 1 million American women have undergone augmentation mammoplasty; 100,000 (10%) will develop or already have developed breast cancer. Between March 1981 and August 1986, 20 patients with previous augmentation mammoplasty were treated for breast carcinoma. All patients had unilateral infiltrating carcinomas and presented with a palpable mass. None of the cancers were occult (discovered mammographically). Thirteen patients (65%) had metastases to axillary lymph nodes. During the same period, 733 nonaugmented patients with breast cancer were treated: 207 (28%) had involved axillary nodes, 194 (26%) had in situ lesions, and 154 cancers (21%) were occult. Augmentation mammoplasty with sillicone-gel-filled implants reduces the ability of mammography, our best diagnostic tool, to visualize breast parenchyma. When compared with our own nonaugmented breast cancer population, augmented patients with breast cancer presented with more advanced disease; they had a higher percentage of invasive lesions and positive axillary nodes, resulting in a worsened prognosis.     

The psychological and social characteristics of patients referred for NHS cosmetic surgery: quantifying clinical need.

PURPOSE: Elective cosmetic surgery is expanding in the UK in both the public and private sectors. Because resources are constrained, many cosmetic procedures are being excluded within the National Health Service. If guidelines on who can receive such surgery are to be evidence-based, information is needed about the level of dysfunction in patients referred for elective surgery and whether this is related to their degree of physical abnormality. METHOD: Consecutive patients referred to a regional plastic surgery and burns unit for assessment for elective cosmetic surgery completed standardised measures of physical and psychosocial dysfunction, and indicated their perception of the degree of their abnormality and their preoccupation with it. We distinguished between patients referred for physical reasons or appearance reasons only, and compared levels of physical and psychosocial dysfunction in each with published values for community and clinical samples. Surgeons indicated patients' degree of objective abnormality, and we identified the relationship of dysfunction with perceived and objective abnormality and preoccupation. RESULTS: Whether patients sought surgery for physical or appearance reasons, physical function was normal. Those seeking surgery for appearance reasons only had moderate psychosocial dysfunction, but were not as impaired as clinical groups with psychological problems. Patients seeking the correction of minor skin lesions for purely appearance reasons reported excellent physical and psychosocial function. Level of function was related (negatively) to patients' preoccupation with abnormality rather than to their perceived or objective abnormality. CONCLUSIONS: In general, patients referred for elective cosmetic surgery did not present with significant levels of dysfunction. Moreover, levels of functioning were related to preoccupation rather than to objective abnormality. Therefore, for most patients, whether surgical treatment is generally appropriate is questionable. Future guidelines must seek to identify the small minority who do have a clinical need for surgery.     

用微机对青霉素皮试作辅助判断的临床应用的探讨

目的探讨微机对青霉素皮试结果作辅助判断的准确性。方法我们根据青霉素皮试常规观察指标设计了青霉素皮试观察记录单,分三个时段观察青霉素皮试的结果。计算机程序判断青霉素皮试的结果是对观察记录经过综合分析得出的。结果应用计算机对376例青霉素皮试的结果进行辅助判定,其结果表明计算机程序对青霉素皮试结果的判断正确性不低于人工判定,经χ2检验P>0.05,说明两者判断结果无显著性。