ICU医院感染影响因素分析

目的分析探讨重症监护病房(ICU)住院患者发生医院感染的相关因素,为降低医院感染率制定措施。方法调查2010年1月-2013年10月ICU 1 718例住院患者临床资料,以单因素和logistic回归分析医院感染的发生率及相关因素。结果通过单因素分析,患者的性别(χ2=20.038,P<0.001)、病情分级(χ2=60.122,P<0.001)、基础疾病数量(χ2=79.123,P<0.001)和住院时间(χ2=730.309,P<0.001)以及医源性的免疫制剂(χ2=24.754,P<0.001)、动静脉插管(χ2=151.528,P<0.001)、泌尿道插管(χ2=25.752,P<0.001)、使用呼吸机(χ2=81.348,P<0.001)、气管插管(χ2=6.691,P=0.010)、气管切开(χ2=483.914,P<0.001)等因素是医院感染的影响因素;通过多因素分析,病情分级(P=0.026)、住院时间(P<0.001)、气管插管(P=0.004)和气管切开(P<0.001)均为医院感染的影响因素。结论影响医院感染的因素有很多,尤其是重症监护病房,要降低医院感染的概率需要从患者和医院各个方面采取多种措施。     

敲降HER-2和TOP2A增强乳腺癌细胞放射敏感性研究

目的 研究HER-2和TOP2A对乳腺癌细胞系SK-Br-3的放射敏感性影响,并探讨二者联合作用,为临床研究奠定基础。方法 分别构建表达HER-2或TOP2A siRNA的重组质粒,并使用lipofectamine 2000将其转染至乳腺癌细胞SK-Br-3中,敲降HER-2和TOP2A的基因表达。2 d后利用蛋白印迹法检测干扰效果,利用流式细胞仪和MTT法分别检测放射处理后细胞凋亡和增殖变化,并检测凋亡和增殖相关蛋白Caspase-3、Bcl-2、Ki-67表达变化。克隆形成实验检测放射敏感性。结果在乳腺癌细胞SK-Br-3中敲降HER-2和TOP2A的表达,放射处理后细胞凋亡率升高,增殖率降低。凋亡标志蛋白活化的Caspase-3表达升高,凋亡抑制蛋白Bcl-2表达降低。细胞增殖标志蛋白Ki-67表达降低。同时敲降HER-2和TOP2A两个基因时促进凋亡和抑制增殖及克隆形成的作用增强,表明这两个基因存在协同效应。结论 敲降HER-2和TOP2A基因在乳腺癌细胞SK-Br-3中的表达后,乳腺癌细胞的放射敏感性提高,细胞凋亡率升高,细胞增殖率降低,克隆形成率降低,且2基因存在协同效应,作用机制可能与Caspase-3、Bcl-2有关的凋亡通路及细胞增殖蛋白Ki-67有关。     

乳腺癌新辅助化疗对血清肝细胞生长因子水平影响的实验研究

目的探讨乳腺癌新辅助化疗对血清肝细胞生长因子水平的影响及相关临床意义。方法应用酶链免疫吸附法（ELIA）检测100例可手术乳腺癌患者新辅助化疗前及术后的血清肝细胞因子水平,并评估其水平与乳腺癌新辅助化疗疗效的关系。结果血清肝细胞生长因子水平与乳腺癌的分期密切相关（P=0．018）;血清肝细胞生长因子水平在治疗前后的变化与新辅助化疗效果密切相关。结论血清肝细胞生长因子可能在乳腺癌的发生发展中起重要作用,可能是预测化疗疗效的独立指标。     

姐妹染色单体交换在小儿急性白血病诊断中的应用

目的探讨姐妹染色单体互换（SCE）技术在小儿急性白血病（AL）诊断中的作用。方法采用SCE技术检测40例不同时期AL患儿，包括初发组20例（其中检测外周血、骨髓各10例），部分缓解（PR）组10例检测骨髓，完全缓解（CR）组10例检测骨髓。另选健康儿童20例作为健康对照组，检测外周血。骨髓和外周血采用SCE技术制作标本，每例分析40个中期分裂相，计数SCE频率。结果初发组骨髓和外周血SCE频率无显著性差异（Pa〉0．05），初发组和健康对照组比较，SCE频率增加，有极显著性差异（Pa〈0．01）。初发组和PR组比较，SCE频率无显著性差异（Pa〉0．05），初发组与CR组比较，SCE频率下降，有极显著性差异（Pa〈0．01）；PR组和CR组比较，SCE频率下降，有极显著性差异（Pa〈0．01）。结论SCE频率变化与疾病的严重程度呈平行关系，SCE在小儿AL中可用来进行协助诊断。     

TTC及FTC方案新辅助化疗治疗乳腺癌的疗效分析

Objective To investigate the efficacy of TTC and FTC regimens as neoadjuvant chemotherapy in breast cancer. Methods Collecting clinical data of 325 patients received neoadjuvant chemotherapy with TIC and FTC regimens from June 2004 to April 2008, among them 138 patients received neoadjuvant chemotherapy with TTC regimen in one group, and 187 patients received neoadjuvant chemotherapy with CTF regimen in the other group. The expression of Topo Ⅱ a in specimen of 325 patients before neoadjuvant chemotherapy were detected by immunohistochemical method. Results Among the 325 cases of neoadjuvant chemotherapy, the overall response rate (RR) was 87.7 % in TIC arm and 67.4 % in FTC arm (P=0.000), but in the group of Topo Ⅱ a(+) Her-2(-), the overall response rate (RR) was 87.8 % in TTC arm and 79.4 % in FTC arm (P=0.266), and in the groups of Topo Ⅱ a(-), there was statistical significance; the pathologic complete response rate (pCR) was 13.7 % in TIC ann and 11.2 % in CTF ann (P=0.491). Conclusion TIC regimen is superior to FTC regimen in the response rate of neoadjuvant chemotherapy, but patients with negative expression of Topo Ⅱ a may get more benefits from 9eoadjuvant taxane and anthracycline chemotherapy.     

C-met在乳腺癌组织中的表达及临床意义

目的了解原癌基因C-met在人乳腺癌组织中表达的规律,以及这种规律与肿瘤生物学行为的关系。方法应用SP免疫组织化学方法,检测60例乳腺浸润性导管癌,20例乳腺纤维腺瘤组织中原癌基因C-met的表达情况。结果原癌基因C-met在60例乳腺浸润性导管癌表达阳性率为65.00%,其与肿瘤组织学分级、临床分期、淋巴结转移相关(P<0.05),而与年龄、月经情况、肿瘤大小无关(P>0.05)。C-met在乳腺癌组织中的表达显著高于乳腺纤维腺瘤组织(P<0.010)。结论原癌基因C-met过度表达与乳腺癌的转移密切相关,对乳腺癌的发生发展起重要作用,对指导临床预防治疗有一定意义。     

TTC及FTC方案新辅助化疗治疗乳腺癌的疗效分析

Objective To investigate the efficacy of TTC and FTC regimens as neoadjuvant chemotherapy in breast cancer. Methods Collecting clinical data of 325 patients received neoadjuvant chemotherapy with TIC and FTC regimens from June 2004 to April 2008, among them 138 patients received neoadjuvant chemotherapy with TTC regimen in one group, and 187 patients received neoadjuvant chemotherapy with CTF regimen in the other group. The expression of Topo Ⅱ a in specimen of 325 patients before neoadjuvant chemotherapy were detected by immunohistochemical method. Results Among the 325 cases of neoadjuvant chemotherapy, the overall response rate (RR) was 87.7 % in TIC arm and 67.4 % in FTC arm (P=0.000), but in the group of Topo Ⅱ a(+) Her-2(-), the overall response rate (RR) was 87.8 % in TTC arm and 79.4 % in FTC arm (P=0.266), and in the groups of Topo Ⅱ a(-), there was statistical significance; the pathologic complete response rate (pCR) was 13.7 % in TIC ann and 11.2 % in CTF ann (P=0.491). Conclusion TIC regimen is superior to FTC regimen in the response rate of neoadjuvant chemotherapy, but patients with negative expression of Topo Ⅱ a may get more benefits from 9eoadjuvant taxane and anthracycline chemotherapy.     

急性肠系膜血管栓塞的诊治体会

目的 探讨急性肠系膜血管栓塞的诊断及治疗方法。方法 对1995年5月—2002年8月收治的18例病人的诊断及治疗情况进行分析。结果 死亡6人，其中1998年以前收治的8例病人死亡4例，死亡率为50％。1998年以后收治的10例病人，由于采用血管造影、CT等检查方法及采用溶栓治疗或Fogarty导管取栓等治疗方法，死亡2人，死亡率为20％。结论 早期诊断早期治疗是治疗的关键。     

男性乳腺癌59例临床病理特征及预后分析

目的 探讨男性乳腺癌的临床病理特点,分析影响预后的相关因素.方法 回顾59例男性乳腺癌患者资料,分析其临床病理特征及5年生存率,用生存分析方法探讨不同临床病理特征对生存的影响.结果 59例患者中位发病年龄为64岁,雌激素受体(ER)和(或)孕激素受体(PR)阳性率为74.6％(44/59).随访9～123个月,5年总生存率为61％,Ⅰ、Ⅱ期患者的生存明显优于Ⅲ、Ⅳ期患者.结论 男性乳腺癌有其独特的临床病理特点.TNM分期是影响预后的重要因素.     

TTC及FTC方案新辅助化疗治疗乳腺癌的疗效分析

Objective To investigate the efficacy of TTC and FTC regimens as neoadjuvant chemotherapy in breast cancer. Methods Collecting clinical data of 325 patients received neoadjuvant chemotherapy with TIC and FTC regimens from June 2004 to April 2008, among them 138 patients received neoadjuvant chemotherapy with TTC regimen in one group, and 187 patients received neoadjuvant chemotherapy with CTF regimen in the other group. The expression of Topo Ⅱ a in specimen of 325 patients before neoadjuvant chemotherapy were detected by immunohistochemical method. Results Among the 325 cases of neoadjuvant chemotherapy, the overall response rate (RR) was 87.7 % in TIC arm and 67.4 % in FTC arm (P=0.000), but in the group of Topo Ⅱ a(+) Her-2(-), the overall response rate (RR) was 87.8 % in TTC arm and 79.4 % in FTC arm (P=0.266), and in the groups of Topo Ⅱ a(-), there was statistical significance; the pathologic complete response rate (pCR) was 13.7 % in TIC ann and 11.2 % in CTF ann (P=0.491). Conclusion TIC regimen is superior to FTC regimen in the response rate of neoadjuvant chemotherapy, but patients with negative expression of Topo Ⅱ a may get more benefits from 9eoadjuvant taxane and anthracycline chemotherapy.