彩色多普勒能量图探测胆囊肿瘤血流的临床意义

目的：应用彩色多普勒能量图（CDPI）在体外检测胆囊肿瘤血管生成，期望发展一种无创伤性评价肿瘤血管生成的方法。方法：36例胆囊癌和26例胆囊腺瘤患者术前均行CDPI探测胆囊肿瘤血流，术后切除标本行MVD和流式细胞计数检查，CDPI检测结果与术后MVD和临床病理资料进行对照分析。结果：CDPI探测的胆囊腺瘤血流以CDPI Ⅰ型、Ⅱ型和周边血流为主，胆囊癌则以CDPIⅢ型、Ⅳ型和内部血流为主（P＜0．05）。CDPI检测到的肿瘤血管数目和分布与MVD测定结果呈正相关（P＜0．05）；CDPIⅢ型、Ⅳ型者，发生淋巴转移者及S＋G2M期指数明显高于CDPI Ⅰ型、Ⅱ型（P＜0．05）。结论：CDPI能够在体外评价胆囊肿瘤血管生成，是鉴别胆囊良恶性肿瘤和判断肿瘤的预后可靠的参数。     

微血管密度在结直肠癌中的表达及意义

目的　探讨微血管密度（ＭＶＤ）在结直肠癌中的表达及其与肿瘤血管生成、临床病理因素和预后的关系。方法　用免疫组化ＳＰ法检测８０例结直肠癌、３０例结直肠腺瘤及３０例正常结直肠组织中ＣＤ３４表达并计算ＭＶＤ值,分析ＭＶＤ值与结直肠癌临床病理因素及预后的关系。结果　结直肠癌ＭＶＤ值为３０.２±６.３,显著高于结直肠腺瘤的１３.１±１.６和正常结直肠组织的６.５±２.７,差异均有统计学意义（Ｐ＜０.０１）。结直肠癌ＭＶＤ值与Ｄｕｋｅｓ分期、肿瘤浸润深度、淋巴结转移显著相关（Ｐ＜０.０１）。结直肠癌高ＭＶＤ值组患者５年生存率为３５.７１％,显著低于低ＭＶＤ值组的７１.０５％,差异有统计学意义（Ｐ＜０.０１）。结论　ＭＶＤ值在结直肠癌中较高,并能够预示肿瘤具有更高的侵袭性及不良预后。     

胆囊癌组织中CD44v6抗原表达的定量研究

目的　探讨CD44v6抗原的表达及含量与胆囊癌的临床病理意义。方法　应用微波 LSAB免疫组织化学法和图像分析技术 ,检测 45例胆囊癌、17例胆囊腺瘤和 10例慢性胆囊炎组织中CD44v6抗原表达及含量。结果　CD44v6抗原表达阳性率及阳性细胞积分光密度值 ,在胆囊癌中显著高于胆囊腺瘤和慢性胆囊炎 (P <0 .0 5 ,P <0 .0 1) ;胆囊癌Ⅱ、Ⅲ级显著高于Ⅰ级 (P <0 .0 5 ,P <0 .0 1) ;有转移的肿瘤显著高于无转移的肿瘤 (P <0 .0 5 ,P <0 .0 1)。结论　CD44v6抗原表达与胆囊癌的发生、细胞增殖、分化和转移相关。对判断胆囊癌的恶性程度、预测生物学行为和预后具有一定临床意义。     

胆囊肿瘤细胞DNA含量的测定及其意义

应用流式细胞术的方法，对４６例胆囊肿瘤的石蜡包埋组织（其中３６例胆囊癌，１０例胆囊腺瘤），５例正常胆囊组织细胞ＤＮＡ含量、细胞Ｓ期百分比（Ｓ％）、细胞增殖指数（ＰＩ）进行分析。３６例胆囊癌中，ＤＮＡ异倍体率为５８．３％（２１／３６），胆囊腺瘤及正常胆囊组织细胞ＤＮＡ均为二倍体。胆囊癌、胆囊腺瘤细胞的ＰＩ及Ｓ％均高于正常胆囊组织细胞（Ｐ＜０．０１），这表明胆囊癌、胆囊腺瘤细胞增殖活跃，３６例胆囊癌中，有３例为腺瘤癌变，因此胆囊腺瘤组织具有恶性变的潜能。胆囊癌的组织类型、组织学病理分级、Ｎｅｖｉｎ分级与Ｓ％、ＰＩ、ＤＮＡ倍体的性质无关，胆囊癌患者的预后与ＤＮＡ倍体的性质无关。     

胆囊癌的超声表现

目的分析胆囊癌的二维声像图和彩色多普勒超声表现.方法经手术病理证实的胆囊癌28例,将其超声表现分三型Ⅰ型胆囊壁局灶肿块型;Ⅱ型胆囊形态完全消失,胆囊窝实性肿物型;Ⅲ型胆囊壁弥漫增厚型.分析胆囊癌对邻近器官侵犯、肝转移、淋巴结转移的彩色多普勒超声表现.结果超声诊断准确率89.3%.Ⅰ型7例肝转移2例,腹腔腹膜后淋巴结转移1例;Ⅱ型8例肝受侵6例,肝转移2例,腹腔淋巴结转移3例;Ⅲ型10例肝受侵7例,肝转移5例,腹腔淋巴结转移6例,腹膜后淋巴结转移6例.28例胆囊癌血流显示率为28.6%(8/28),最大流速14.7～28.8 cm/s,RI 0.65～0.83.结论Ⅱ型与Ⅲ型肝受侵率较Ⅰ型高,Ⅲ型肝转移和淋巴结转移率较Ⅰ型和Ⅱ型高,超声扫描不仅能检出原发肿瘤,而且能显示肿瘤的侵犯范围、有无转移,为判断能否手术及合理制订综合治疗方案提供帮助;彩超扫描有血流信号时能增强对胆囊癌的诊断信心,但在没有血流信号时,不能完全除外胆囊癌的诊断.     

异长春花碱,长春地辛联合方案治疗72例晚期非小细胞肺癌的临床对比 …

目的 比较ＮＰ和ＭＶＰ方案治疗Ⅲ、Ⅳ期ＮＳＣＬＣ的临床疗效和毒性。方法 选择病理证实Ⅲ、ⅣＳＣＬＣ７２便,随机分成２组,３４例为ＮＰ组,３８例为ＭＶＰ组。ＮＶＢ剂量为２５ｍｇ／ｍ＾２,ＰＤＤ２５ｍｇ／ｍ＾２,ＶＤＳ３ｍｇ／ｍ＾２,ＭＭＣ６ｍｇ／ｍ＾２,３周重复,２周期后评价疗效。用上述方案进行对比治疗。结果 ＮＰ组和ＭＶＰ组缓解率分别为４７．１％,两级差异无显著性。Ⅲ、Ⅳ期缓解率分别是５０％、４２     

非小细胞肺癌的微血管密度检测及其意义

目的探讨微血管密度（ＭＶＤ）检测对判断非小细胞肺癌（ＮＳＣＬＣ）患者预后的意义。方法取７１例术前未经放疗、化疗的ＮＳＣＬＣ石蜡标本应用ＦＶⅢ因子相关抗原（ＦＶⅢ－Ａg）抗体免疫组化（ＩＨＣ）方法标记肿瘤组织内的血管内皮细胞，计算２００倍视野下血管最丰富区的ＭＶＤ，即“热点”ＭＶＤ（h－ＭＶＤ），另外随机取５个２００倍视 野下血管相对丰富区的ＭＶＤ，计算平均ＭＶＤ（a-ＭＶＤ）。统计学采用t检验和相关数     

ＣＴ灌注成像在肿瘤血管生成中的应用

血管生成是恶性肿瘤的重要特点,对其生长、侵袭及转移起到关键性作用。早期已有研究证实抑制血管生成可以增强治疗肿瘤的疗效。但传统分析肿瘤血管生成的标准方法为组织病理学上微血管密度（ＭＶＤ）计数,有创且间接评估肿瘤血管,不能提供体内肿瘤血管生成方面的信息。ＣＴ灌注成像（ＣＴＰＩ）作为一种无创、定量的方法,可以用来评估活体内肿瘤的血流动力学,以及监测抗血管生成疗效,本文就ＣＴＰＩ在肿瘤血管生成研究中的研究进展作一综述。     

胃粘膜上皮异型增生和胃癌组织CD44V6表达的免疫组化研究

为了探讨ＣＤ４４Ｖ６表达与胃癌发生发展的关系，采用ＳＰ免疫组化染色方法，检测２０例正常胃粘膜上皮，４３例异型增生和８５例胃癌组织ＣＤ４４Ｖ６的表达情况。结果显示，正常胃粘膜无ＣＤ４４Ｖ６表达；异型增生ＣＤ４４Ｖ６阳性表达率为３０．２％（１３／４３），其中Ⅰ级、Ⅱ级、Ⅲ级异型增生阳性率分别为１３．６％（３／２２）、３３．３％（４／１２）和６６．７％（６／９），提示ＣＤ４４Ｖ６表达阳性率与异型增生严重程度密切相关（Ｐ＜０．０５）；胃癌组织阳性表达率为７４．１％（６３／８５），其表达阳性率和染色强度均高于异型增生，Ⅰ期、Ⅱ期胃癌ＣＤ４４Ｖ６染色强度和阳性表达率均显著低于Ⅲ期和Ⅳ期（Ｐ＜０．０５）。结果表明ＣＤ４４Ｖ６表达与胃癌发生发展密切相关，并发生于癌变的早期阶段，检测ＣＤ４４Ｖ６表达将有助于胃癌的早期诊断     

肝细胞癌中NOS和VEGF的表达及其与肿瘤血管形成的关系

目的 研究Ⅱ、Ⅲ型一氧化氮合酶（ｉＮＯＳ、ｃＮＯＳ）和血管内皮生长因子（ＶＥＧＦ）在肝细胞癌中的表达及其与肿瘤血管形成的关系。方法 应用免疫组化方法检测７１例肝细胞癌患者手术切除石蜡包埋标本ｉＮＯＳ、ｅＮＯＳ、ＶＥＧＦ的表达,抗ＣＤ３４单克隆抗体显示血管内皮细胞。根据ＣＤ３４阳性的血管内皮细胞计数来测定肿瘤微血管密度（ＭＶＤ）。结果 ｉＮＩＳ、ｅＮＯＳ分别在８１．３％、８５．９％的肝癌中阳性表达,     

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.