年轻宫颈癌患者行腹腔镜下卵巢移位及阴道延长治疗的疗效分析

目的 探讨年轻宫颈癌患者腹腔镜下行卵巢移位及阴道延长治疗的临床优势.方法 按照手术方式不同将96例宫颈癌患者分为实验组(50例)和对照组(46例),实验组患者腹腔镜下行广泛全子宫切除术+盆腔淋巴结清扫术+卵巢异位+阴道延长术,对照组患者行腹式广泛全子宫切除术+盆腔淋巴结清扫术+卵巢异位+阴道延长术,比较两组治疗效果.结果 实验组患者术中出血量明显少于对照组,差异具有显著性(P＜0.05);两组患者手术时间和淋巴结切除个数比较,差异无统计学意义(P＞0.05);实验组患者肛门排气时间和术后住院时间均明显短于对照组,差异具有显著性(P＜0.05);实验组患者术后并发症发生率明显低于对照组,差异具有显著性(P＜0.05);两组患者手术前后FSH、LH、E2水平、阴道长度与性功能评分比较,差异无统计学意义(P＞0.05);组间比较,差异也无统计学意义(P＞0.05).结论 年轻宫颈癌患者行腹腔镜下卵巢移位及阴道延长治疗创伤小、术后恢复快、并发症少,对患者性功能和内分泌水平影响小,临床应用价值较高.     

手辅助腹腔镜胃癌根治术的疗效及对患者CEA、CA199的影响

目的研究手辅助腹腔镜胃癌根治术的临床治疗效果以及对患者血清CEA和CA199的影响。方法对采用手辅助腹腔镜胃癌根治术治疗的58例患者临床资料进行回顾性分析,并对治疗效果及治疗前后患者血清肿瘤标记物CEA和CA199变化情况进行比较。结果采用手辅助腹腔镜胃癌根治术治疗的58例患者无手术死亡病例,发生胃无力2例、切口感染1例,经治疗均痊愈。患者CEA水平从术前的(20.4±2.1)ng/ml降低至术后的(4.3±1.8)ng/ml、患者CA199水平从术前的(63.1±28.9)U/ml降低至术后的(23.6±11.2)U/ml,手术前后差异均有统计学意义(P<0.05)。结论手辅助腹腔镜胃癌根治术操作难度小,疗效确切,血清肿瘤标记物CEA和CA199降低明显,术后并发症少,可作为胃癌治疗的新术式。     

放疗对宫颈癌根治术患者卵巢功能影响

目的 在保留并移位卵巢的ⅠB1-ⅡA2期根治术后需辅助放疗的年轻宫颈癌患者中,评估移位卵巢剂量学参数与临床不同卵巢功能状态之间相关性。方法 回顾2015-2017年间86例患者疗前和疗后2年内移位卵巢功能和临床相关症状,并评价放疗技术中移位卵巢的剂量学参数以及移位卵巢的功能状态之间的相关性。术后放疗采用不同体外保护移位卵巢,68例IMRT或VMAT,18例二维等中心放疗。结果 卵巢和PTV最近距离与卵巢剂量≥V5Gy呈负相关(P=0.025)。V8Gy、Dmean与疗后FSH(为卵巢血清卵泡刺激素,FSH)呈正相关(P=0.011、0.020)。即V8Gy体积越大Dmean越高,疗后FSH越高卵巢功能越差。二维技术中≥V5Gy低于三维技术,剂量降低明显。疗后卵巢功能正常者平均年龄33.4岁,而卵巢功能衰竭者平均年龄39.6岁(P=0.007)。不同卵巢状态患者间保留卵巢数目、是否同步化疗均相近,但与疗前FSH、E2(雌二醇)水平相关,即疗前FSH水平越高E2越低,疗后卵巢FSH水平越高E2越低。疗前保留卵巢但功能衰竭者均进行了新辅助化疗且年龄略高。结论 年龄,卵巢 V_{8 Cy}、D_mean,悬吊卵巢与 PTV 最近距离,疗前有无新辅助化疗及放疗技术均会影响移位卵巢功能的保护。     

放疗对55例早期宫颈癌患者移位卵巢内分泌功能的影响

摘 要：［目的］ 研究早期宫颈癌患者卵巢移位术后放疗前后卵巢内分泌功能的变化。［方法］ 55例早期宫颈癌患者行卵巢移位术并且行术后放疗,比较其放疗前、放疗后１个月、3个月、6个月、12个月的血清中卵泡刺激素（FSH）、黄体生成素（LH）和雌二醇（E2）水平,术后随访患者有无围绝经期症状。［结果］ 卵巢移位术后放疗后1个月、3个月、6个月、12个月的FSH和LH、E２水平与放疗前比较无统计学差异(P>0.05),所有患者术后放疗前及放疗后1个月、3个月、6个月、12个月均未出现围绝经期症状。［结论］ 术后放疗不会显著性影响患者移位卵巢功能。     

腹膜外卵巢移位术与改良卵巢移位术对宫颈癌患者卵巢功能的影响

目的探讨腹膜外卵巢移位术与改良卵巢移位术对宫颈癌患者卵巢功能的影响。方法选取2010年3月至2015年9月间山东潍坊临朐县人民医院收治的140例宫颈癌患者,采用随机数表法将患者分为观察组和对照组,每组70例。观察组行改良卵巢移位术,对照组行腹膜外卵巢移位术。比较两组患者治疗前后孕酮(P)、卵泡刺激素(FSH)、黄体生成素(LH)及雌二醇(E)含量,并发症发生率及随访24周性生活满意度。结果两组患者治疗前P、FSH、LH及E值比较,差异均无统计学意义(均P>0.05)。两组患者治疗后较治疗前比较P值升高、FSH、LH和E值降低,但差异均无统计学意义(均P>0.05)。两组治疗后P、FSH、LH及E值比较差异无统计学意义(P>0.05)。观察组并发症发生率为10.0%,对照组并发症发生率为21.4%,观察组较对照组相比并发症发生率明显降低,差异有统计学意义(P<0.05)。对照组性生活满意率为81.4%,观察组性生活满意率为91.4%,观察组较对照组比较性生活满意明显提高,差异有统计学意义(P<0.05)。结论腹膜外卵巢移位术与改良式卵巢移位手术治疗宫颈癌都可以有效保留卵巢的功能,改良式卵巢移位术可减少并发症的发生,显著提高患者术后性生活满意度。     

腹腔镜下子宫肌瘤剔除术对患者卵巢功能及血清创伤反应指标的影响

目的探讨腹腔镜下子宫肌瘤剔除术对患者卵巢功能及血清创伤反应指标的影响。方法选取2017年5月至2018年5月间新疆医科大学第五附属医院收治的100例子宫肌瘤患者,采用奇偶数分组法分为观察组和对照组,每组50例。观察组患者采用腹腔镜下子宫肌瘤剔除术治疗,对照组患者采用传统手术治疗,比较两组患者的促黄体素、促卵泡刺激素、雌二醇、环磷酰胺、血清缺血修饰清蛋白、肌红蛋白、前列腺素E2、白细胞介素-6和心肌细胞P物质。结果治疗后,观察组患者促黄体素(17. 22±1. 35) U/L、促卵泡刺激素(20. 35±1. 24) U/L、雌二醇(224. 69±8. 53)pmol/L、环磷酰胺(8. 42±1. 33) k U/L、血清缺血修饰清蛋白(65. 33±3. 18) U/L、肌红蛋白(22. 19±1. 43) ng/ml、前列腺素E2(115. 28±8. 45) pg/ml、白细胞介素-6(6. 18±1. 28) pg/ml和心肌细胞P物质(4. 27±1. 35)μg/ml,均优于对照组的(22. 41±1. 67) U/L、(22. 44±2. 61) U/L、(254. 17±8. 12)pmol/L、(13. 17±1. 85) kU/L、(70. 42±4. 22) U/L、(26. 37±2. 55) ng/ml、(155. 56±9. 85) pg/ml、(7. 59±1. 53) pg/ml和(5. 86±1. 42)μg/ml,差异均有统计学意义(均P <0. 05)。结论对子宫肌瘤患者采用腹腔镜下子宫肌瘤剔除术治疗效果明显,可改善卵巢功能。     

宫颈癌新辅助化疗不同给药途径对卵巢功能影响

摘 要：［目的］ 探讨局部晚期宫颈癌年轻患者在术前经不同给药途径新辅助化疗后对术后卵巢功能的影响。［方法］ 选取2014年7月至2015年12月局部晚期宫颈癌年轻患者70例为研究对象,按照随机数字法则分为两组,其中动脉化疗组38例,静脉化疗组32例,两组患者均在术前采取TP化疗方案,术后进行BOMP化疗方案,比较两组手术前后卵泡刺激素( FSH) 、血清雌二醇( E2)、黄体生成素( LH) 变化以评估对卵巢功能的影响。［结果］ 与术前及术后1个月对比,动脉化疗组患者在术后6个月FSH水平显著性降低,E2水平显著性升高（P<0.05）,LH水平无显著性变化;静脉化疗组患者手术前后FSH、E2及LH水平均无显著性变化（P>0.05）。 动脉治疗组术后3个月排卵功能恢复16例,占42.11%,静脉化疗组术后3个月排卵功能恢复13例,占40.63%,两组对比差异无统计学意义（P<0.05）。［结论］ 经动脉介入栓塞化疗与静脉化疗对年轻局部晚期宫颈癌患者的卵巢功能的远期影响无显著性差异,均可用于局部晚期宫颈癌的治疗。     

宫颈癌患者血清CYFRA21-1、TPS、CA125和CEA表达的临床分析

目的:探讨宫颈癌患者血清CYFRA21-1、TPS、CA125、CEA表达和临床的相关性。方法:随机选取28例宫颈癌患者和同时期的宫颈上皮内瘤样病变患者31例,健康对照人群35例。化学发光分析法检测血清CYFRA21-1、TPS、CA125和CEA水平,观察其和宫颈癌临床分型、分期的关系。结果:宫颈癌组CYFRA21-1、TPS、CA125、CEA检出水平最高,分别为:（5.15±36.35）ng/ml、（129.45±74.73）U/L、（58.35±17.47）U/ml、（15.86±9.35）ng/ml;宫颈上皮内瘤样病变检出水平其次,分别为:（0.96±0.45）ng/ml、（53.12±21.56）U/L、（36.24±14.23）U/ml、（3.28±1.74）ng/ml;健康人群最低,分别为:（0.61±0.32）ng/ml、（36.71±17.35）U/L、（12.69±4.51）U/ml、（1.26±0.86）ng/ml,以上两两比较差异均有显著性差异(P<0.05)。宫颈癌Ⅰ-Ⅱ期和宫颈癌Ⅲ-Ⅳ期在CYFRA21-1、TPS、CA125、CEA水平上比较差异也有统计学意义（P<0.05）。结论:血清CYFRA21-1、TPS、CA125、CEA在宫颈癌患者中的表达明显高于宫颈上皮内瘤样病变和健康受试者,为临床诊治研究提供了新的思路和方向。其在宫颈癌诊断中是否具有较好的特异性,需做进一步的临床研究。     

年轻宫颈癌根治术时行卵巢移位及阴道延长术8例

早期宫颈癌生存率较高,为了使患者治疗后能高质量生活,近几年国内外学者提倡年轻患者作根治术的同时行卵巢移位术,我科还加作阴道延长术(国内很少报道),这样,既避免因雌激素缺乏导致一系列临床更年期症状,又使患者夫妻生活不受影响。为此我们自1993年1月至1995年5月对8例年轻早期子宫颈癌患者作根治术同时行卵巢移位术及阴道延长术,效果满意,报告如下:     

卵巢移位对宫颈癌患者性激素和性生活质量的影响

目的探讨宫颈癌根治术中卵巢移位对患者性激素水平和性生活质量的影响。方法符合条件的宫颈癌根治术患者67例入组。根据治疗方法分组：对照组20例,未行卵巢移位及术后放化疗;研究组：A组23例行卵巢移位但术后未放化疗;B组24例行卵巢移位并辅助术后放化疗。采用性激素检测评价卵巢功能,采用问卷调查评价性生活质量,彩超评价卵巢形态。对比3组患者卵巢功能和性生活质量,评价卵巢移位的安全性和有效性。结果对照组和A组中各有2例卵巢功能衰退;B组24例中卵巢功能衰退22例,卵巢功能衰退率显著高于对照组。A组性激素水平均数与对照组相近;B组血清LH、FSH水平均数显著高于对照组,而E2、P水平均数显著低于对照组。A组术后性生活质量与对照组相近;B组术后性生活质量显著差于对照组。随访期内全组均无卵巢转移和卵巢良性疾病发生。结论宫颈癌术中卵巢移位是安全的;单纯卵巢移位不影响卵巢功能及性生活质量;卵巢移位后行放化疗者卵巢功能保全率低,性生活质量下降;改进手术方法和放疗设野可能有利于提高卵巢功能及性生活质量。     

Dermatomycosis in Goats in India

Summary: In an extensive survey involving 2176 goats 1.56% of goats manifested clinical lesions of ringworm infection. Animals below the age of 6 months were affected most (4.20%). The incidence of infection was higher during the winter months. T. verrucosum, T. mentagrophytes and M. gypseum were isolated from the skin scrapings of 12, 4, and 2 goats respectively. It is suggested that the infected animals could be a source of disease to human population in which the zoophilic dermatophyte invasion is characterized by severe inflammatory lesions of the skin. The zoonotic importance of different dermatophytes is stressed.
Zusammenfassung: In einer ausgedehnten Untersuchung an 2176 Ziegen wurden bei 1,56% klinische Zeichen einer Hautmykose festgestellt. Tiere, die jühger als 6 Monate alt waren, zeigten mit 4,20% am häfigsten Krankheitssymptome. In den Wintermonaten war die Erkrankungshäufigkeit am gröBten. T. vermcosum, T. mentagrophytes and M. gypseum wurden jeweils von 12,4 bzw. 2 Ziegen isoliert. Die inflzierten Tiere köinnen eine Infektionsquelle für die menschliche Bevölkerung darstellen und dort Mykosen mit stark entzündlichen Veränderungen auslösen. Die Bedeutung verschiedener Dermatophyten als Erreger von Zoonosen wird hervorgehoben.     

Trends in zygomycosis in children

Zygomycosis, or mucormycosis, is associated with significant morbidity and mortality in both children and adults. Studies in adults have shown an increase in the incidence of zygomycosis, particularly among haemtopoietic stem cell transplant (HSCT) recipients and patients with haematologic malignancies. There is a paucity of data on the epidemiology of zygomycosis in children. We performed a retrospective analysis to describe trends in zygomycosis between 1 January 2003 and 31 December 2010. We used the Pediatric Health Information System (PHIS) database to identify paediatric patients who were diagnosed with zygomycosis during the study period. Administrative data on diagnoses, demographics, underlying conditions and clinical experiences were collected. Summary statistics were calculated and tests for trend were conducted. We identified 156 unique patients with zygomycosis. The prevalence of zygomycosis did not significantly increase over time (P=0.284). The most common underlying condition was malignancy (58%) and over half received intensive care. Voriconazole utilisation among all hospitalised children significantly increased during the period (P=0.010). Our study demonstrates that the incidence of zygomycosis is not significantly increasing. During the time period there was a significant increase in the use of voriconazole among children.     

Increased apoptosis in cancer cells in vitro and in vivo by ceramides in transferrin-modified liposomes

Lysosomes are a promising therapeutic target for induction apoptosis in cancer cells due to lysosomal membrane permeabilization (LMP) leading to leakage of hydrolytic enzymes, especially the cathepsins, into the cytoplasm. We hypothesized that with the modification of the ceramide-loaded liposomes with transferrin (Tf), we would achieve both tumor targeting and increased delivery of lysosome-destabilizing agents, such as ceramides to lysosomes, to initiate LMP-induced apoptosis. We prepared Tf-modified (TL) and plain (PL) liposomes and loaded with short (C6)- or long (C16) N-acyl chain ceramides. Uptake, intracellular localization of liposomes, stability of the lysosomal membrane and release of cathepsin D were investigated on Hela cells by fluorescence microscopy and flow cytometry. Apoptosis was evaluated by binding of fluorescently-labeled Annexin V. Antitumor and pro-apoptotic effects of C6Cer-loaded Tf-liposomes were demonstrated in vivo in an A2780-ovarian carcinoma xenograft mouse model. TL were internalized specifically via the TfR-dependent endocytic pathway and localized within the endosome-lysosomal compartment. Ceramide-loaded Tf-liposomes significantly increased apoptosis compared with ceramide-free and ceramide-loaded non-modified liposomes. The treatment of cancer cells with TL led to increased LMP and cytoplasmic relocation of the intralysosomal cathepsin D. A strong antitumor and pro-apoptotic effect of C6Cer-loaded TL was also demonstrated in vivo in an A2780-ovarian carcinoma xenograft mouse model. The lysosomal accumulation of ceramides delivered by Tf-liposomes initiates the permeabilization of the lysosomal membranes required for the release of lysosomal cathepsins into the cytoplasm and initiation of the cancer cell apoptosis both in vitro and in vivo.     

Ringworm in animals in a farm in Assiut

Bericht über das Auftreten von Hautmykosen bei Tieren auf der Farm der Landwirtschaftlichen Fakultät der Universität Assiut. Von 70 Kälbern waren 42 pilzkrank, davon 22 durch T. mentagrophytes, 20 durch T. verrucosum. Von 180 Kühen waren 8 pilzbefalien, sämtlich durch T. mentagrophytes. Von 2 kranken Bullen wurde T. verrucosum isoliert. Auch die 3 Pferde und 2 Maultiere der Farm waren pilzinfiziert; Erreger war in diesen Fällen T. equinum. Auch ein Kalb war von T. equinum befallen. Die gleiche Pilzart wurde ferner von 3 Tierpflegern isoliert, die Pilzherde am Hals und an den Armen aufwiesen.     

Socioeconomic factors in cancer in Sweden

It is well known that certain cancers have shown clustering in socioeconomic groups, but limited data are available on recent results and time trends in such clustering. We determined standardized incidence ratios (SIR) for cancer, adjusted for age, period, region, parity and age at first childbirth among men and women in 6 socioeconomic groups based on the Swedish Family-Cancer Database. Persons had to be identified with the same socioeconomic status in the census of years 1960 and 1970, or of years 1960, 1970 and 1980; the comparison group was all people according to the same censuses. Cancers were followed from years 1970 to 1998 or from 1980 to 1998. Both increased and decreased SIRs were found, and a consistent pattern emerged, although the overall SIRs for cancer did not differ much, the lowest being for farmers (0.85) and the highest for professional men (1.07) and women (1.11). At individual sites, manual workers were at risk of tobacco-, alcohol- and occupation- and human papilloma virus-related cancers and at a decreased risk at most other cancers. Manual workers and farmers showed an excess of stomach cancer; professionals had an excess of melanoma and squamous cell skin cancer. Male and female SIRs correlated highly for manual and blue-collar workers and for professionals. The overall population-attributable fraction for selected sites was 16.7% for men and 10.9% for women and it was highest, over 50%, for lung cancer in both genders.     

Survey of changes in dietary preferences in cancer patients in China

Objective The aim of this study was to investigate the changes in dietary preferences in cancer patients in China and to determine the need for encouraging the adherence to a sensible diet among such patients.Methods A total of 468 cancer patients were interviewed using a self-designed questionnaire focusing on changes in the intake of specific foods. Data were analyzed using SPSS 16.0. Results Most patients completely avoided roosters and carp(73.1%), condiments(51.9%), and meat of aquatic species(40.4%). All other types of the specific foods were completely avoided by different subpopulations of the patients.Conclusion In addition to focusing on disease treatment, medical professionals need to help cancer patients overcome barriers associated with the customs of avoiding specific foods encompassed by the term ”fawu” and provide them with dietary guidance in order to prevent negative nutritional effects.     

Advances in cancer epidemiology in Japan

Epidemiologists in Japan have been performing calculations to estimate nationwide cancer incidence rates as well as 5‐year survival rates using population‐based cancer registry data. There have been remarkable changes in cancer incidence and/or mortality in cancers of the lung, liver and stomach, which were thought to be attributed to the changing impact of exposure to cigarette smoking, chronic hepatitis C virus infection and Helicobacter pylori infection, respectively. In systematic reviews providing evidence in risk/protective factors for cancer sites using case–control and cohort studies of the Japanese population, there were associations between cancer sites (esophagus, stomach, colo‐rectum, liver, pancreas, lung and breast) and various lifestyle factors. In the past 10 years, a hospital‐based case–control study at Aichi Cancer Center provided valuable evidence of gene‐environment interaction on the development of cancer [i.e., the effects of aldehyde dehydrogenase‐2 (ALDH2) polymorphism and heavy alcohol drinking on esophageal cancer, ALDH2 polymorphism and smoking on lung cancer, methylenetetrahydrofolate reductase polymorphism and heavy alcohol drinking on pancreatic cancer]. The database with stored DNA was also used and identified seven loci containing significant but low‐penetrance polymorphisms associated with the development of breast cancer. These findings together with established risk factors are likely to be useful to predict personalized breast cancer risk in East Asian women. In 2005, the Japan Multi‐Institution Collaborative Cohort (J‐MICC) study was launched to elucidate gene‐environment interactions as well as to confirm preclinical diagnostic biomarkers of cancer. J‐MICC, which has recruited 92,000 healthy individuals by the end of 2012, will follow the individuals until 2025.     

Foreign bodies in ENT in a teaching hospital in Eastern India

Objective

To evaluate the nature, common sites, modes of presentation of various foreign bodies (FB) in Ear, Nose and Throat (ENT).

Materials and methods

Observational retrospective study carried out at Vivekananda Institute of Medical Sciences, Ramakrishna Mission Seva Pratishthan. The study period was between Jan 2006 to Jan 2007. The information obtained from the hospital record books.

Results

Four hundred and eighty-two patients presented in the Department of Otorhinolaryngology of Vivekananda Institute of Medical Sciences, in the study period with FB in their ENT. Out of 482 pts, the commonest location of FB was to be in throat with 302 pts (62%) followed by ear with 119 pts (25%) and nose 61 pts (13%). Amongst the FB in throat the commonest was fish bone and the commonest site being tonsils. Artificial denture accounted for a significant number of 13 (4.3%). External auditory canal was the commonest site of FB lodgment in ear found in 118 patients (99.16%). Nasal FB were found in 61 patients; more common in pediatric age group (98.36%).

Conclusion

From this study we have found that FB lodgement is a very common complaint with which patients come to otolaryngologist. The commonest site of FB lodgement is in the throat. Most of the FB could be removed in emergency room (ER) with or without Local Anesthesia.     

整合素在急性白血病中的研究进展

急性白血病是一种早期造血干/祖细咆的恶性克隆性疾病.微小残留病和耐药被认为是其复发和难治的根源.近来,越来越多的证据显示白血病细胞通过与骨髓微环境中的基质细胞或细胞外基质相互作用促进其存活,并增强其对常规化疗药物的耐药.整合素是介导细胞与细胞外基质（细胞与非细胞成分）粘连的最主要黏附分子,在细胞增殖、存活等生物学过程中发挥关键作用,但作用机制尚不完全清楚.现就目前揭示的整合素及肿瘤微环境在急性白血病发生、发展中的作用进行综述.